Abstract
BackgroundThe aim of this study was to evaluate the clinical reliability of ultrasound (US) examination using relative laryngeal movement of 40% as a cutoff point to diagnose pharyngeal abnormalities of swallowing using ultrasonographic examination in dysphagic cerebral palsy (CP) patients and comparing its results with a flexible fiberoptic endoscope.MethodsTwenty-five cerebral palsy children suffering from clinical dysphagia were included in this study. The rest distance between the thyroid cartilage and the hyoid bone and the shortest distance between them during swallowing were measured by ultrasound, then the approximation distance and the percentage of relative laryngeal movement were calculated. All children also have been submitted for flexible fiberoptic endoscopy (FEES).ResultsThe mean value of the percentage of relative laryngeal movement was significantly less in the CP children with pharyngeal phase abnormality diagnosed by the flexible fiberoptic endoscope (p < 0.001). The mean of relative laryngeal movement in CP patients with and without pharyngeal abnormality diagnosed by the flexible fiberoptic endoscope was 20.10 ± 13.73 and 66.19% ± 3.42 respectively.ConclusionUltrasound can efficiently measure the relative laryngeal movement, and as it gives a numerical value, it can be used as a follow-up bedside test in children suffering from dysphagia.
Highlights
The aim of this study was to evaluate the clinical reliability of ultrasound (US) examination using relative laryngeal movement of 40% as a cutoff point to diagnose pharyngeal abnormalities of swallowing using ultrasonographic examination in dysphagic cerebral palsy (CP) patients and comparing its results with a flexible fiberoptic endoscope
Dynamic laryngeal movement during swallowing with laryngeal elevation and hyoid–larynx approximation is an essential component of swallowing [6, 7], and it is associated with bolus passage through the pharynx
The aim of this work is to assess the diagnostic performance of US for diagnosing abnormalities in the pharyngeal phase of swallowing in dysphagic Cerebral palsy (CP) patients using reduced relative laryngeal movement of ≤ 40% compared to flexible fiberoptic endoscopy
Summary
The aim of this study was to evaluate the clinical reliability of ultrasound (US) examination using relative laryngeal movement of 40% as a cutoff point to diagnose pharyngeal abnormalities of swallowing using ultrasonographic examination in dysphagic cerebral palsy (CP) patients and comparing its results with a flexible fiberoptic endoscope. The fiberoptic endoscopy (FEES) is used in the assessment of swallowing, the pharyngeal stage [3]; it can be used to demonstrate the penetration and/or aspiration [4], but it does not provide direct information on laryngeal elevation or hyoid–larynx approximation [5]. The aim of this work is to assess the diagnostic performance of US for diagnosing abnormalities in the pharyngeal phase of swallowing in dysphagic CP patients using reduced relative laryngeal movement of ≤ 40% compared to flexible fiberoptic endoscopy Dynamic laryngeal movement during swallowing with laryngeal elevation and hyoid–larynx approximation is an essential component of swallowing [6, 7], and it is associated with bolus passage through the pharynx, Ultrasound (US) can detect and recognize the hyoid bone and thyroid cartilage, and the percentage of hyoid–laryngeal approximation can be calculated by the measurement of the approximation distances of the two structures [5].
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