An Exploratory Study of Hyoid Visibility, Position, and Swallowing-Related Displacement in a Pediatric Population
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ORIGINAL ARTICLE
An Exploratory Study of Hyoid Visibility, Position, and SwallowingRelated Displacement in a Pediatric Population Aimee Riley1 • Anna Miles1,4
•
Catriona M. Steele2,3
Received: 7 May 2018 / Accepted: 5 September 2018 Ó Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Hyoid position and swallowing-related displacement has been studied in healthy adults and adults with dysphagia, but research is limited in children. The aim of this study was to investigate feasibility of visualizing and measuring position and swallowing-related displacement of the hyoid bone in children. We explored relationships between hyoid displacement, age and aspiration risk scores. Pediatric swallowing data were extracted from a videofluoroscopy database containing recordings from 133 children aged 9 days to 21 years (mean 36 months, SD 3 years) referred for videofluoroscopy due to concerns regarding their feeding. Children presented with varying etiologies: neurological, structural, respiratory, and other diagnoses. Still shot images were extracted for the frame of hyoid peak position and a frame showing the hyoid at rest. Pixel-based image analysis software was used to measure hyoid position in three directions (X = anterior, Y = superior, XY = hypotenuse) relative to C4 vertebra. Difference between rest and peak position was used to measure hyoid displacement (X, Y and XY). The hyoid was not visible in children \ 9 months, but could be reliably visualized and measured in 49 children. Descriptive statistics were collected for hyoid parameters. Age was significantly associated with rest (Y and XY) and peak (Y and XY) hyoid position parameters as well as anterior displacement. No significant associations were observed between hyoid parameters and aspiration risk scores. This study successfully explored hyoid visibility, position and swallowing-related displacement in a pediatric population. Hyoid can be reliably visualized and tracked through videofluoroscopy in children [ 9 months of age. Keywords Deglutition Deglutition disorders Dysphagia Videofluoroscopy Pediatric Hyoid
Introduction Swallowing is a complex process through which children and adults receive essential nutrition and hydration in order to sustain life. Any anatomical, respiratory, or neurologic disturbance to this process can result in swallowing & Anna Miles [email protected] 1
Speech Science, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
2
Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
3
Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
4
Speech Science, School of Psychology, Tamaki Campus, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
difficulties (dysphagia). Dysphagia often presents as penetration–aspiration (food/fluids/saliva entering the airway) or residue (food/fluids/saliva remaining in the mouth or pharynx after swallowing), posing a si
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