Abstract
Ultrasonography has gained increasing attention as a non-invasive and radiation-free instrument for the assessment of swallowing function. In the past decades, an extensive repertoire of ultrasonographic techniques, such as, B-mode dynamic scanning, pixel analysis, M-mode, Doppler, 3D reconstruction, and sonoelastography, has been applied in the evaluation of oropharyngeal structures and movement. Yet, a universal consensus on the examination protocols and clinical implications remains to be established. This review aimed to provide a brief introduction of the application of ultrasound in dysphagia assessment and intervention, encompassing the ultrasonography of swallowing-related muscles, tongue movement, and hyolaryngeal excursion, as well as ultrasound-guided interventions in the management of dysphagia. In addition to non-invasiveness, ultrasonography, a portable, easy to use, and low-cost technique, could compliment videofluoroscopic swallowing study as a first-line screening and follow-up tool for the evaluation of swallowing function, although further study is warranted to provide quantitative diagnostic and prognostic values. Finally, ultrasonography aids in the precisely targeted injection of botulinum toxin in patients exhibiting oropharyngeal muscle spasticity.
Highlights
Oropharyngeal dysphagia affects up to one-third of older adults [1] and 40% of institutionalized residents [2]
Radiation exposure hinders the use of videofluoroscopic swallowing study (VFSS) as a tool for screening or serial follow-ups, it is considered the gold standard for assessing oropharyngeal dysphagia
There is significant variation in examination techniques and methodology, and the clinical diagnostic value of US in dysphagia management remains to be established. In this narrative review, we aimed to provide abroad overview of various US applications in the evaluation of swallowing function, with a particular focus on its clinical implications with regard to diagnosis and management of oropharyngeal dysphagia based on our experience
Summary
Oropharyngeal dysphagia affects up to one-third of older adults [1] and 40% of institutionalized residents [2]. A formal screening of swallowing function effectively reduces the risks of pneumonia [9, 10]. Standard instrumental swallowing examinations such as the videofluoroscopic swallowing study (VFSS) [11] and fiberoptic endoscopic evaluation of swallowing (FEES) [12] are often not accessible in community settings, long-term care facilities, or many hospitals. Radiation exposure hinders the use of VFSS as a tool for screening or serial follow-ups, it is considered the gold standard for assessing oropharyngeal dysphagia. FEES is suitable for bedside evaluation, but there is a white-out during the pharyngeal phase of swallowing. Ultrasound in Dysphagia the endoscopic tube may cause discomfort and affect normal swallowing physiology
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