Submental ultrasonongraphy in assessing oropharyngeal swallowing disorders in children with cerebral palsy

Abstract

Objective To explore the application of submental ultrasonongraphy (SUS) in the assessment of oropharyngeal swallowing disorders in children with cerebral palsy. Methods Seventeen children with cerebral palsy and oropharyngeal swallowing difficulties (7 on nasal feeding, 10 on oral feeding) constituted the treatment group while 20 normal counterparts formed the control group. SUS was applied to measure any changes in the thickness of the tongue muscle and the range of hyoid bone displacement when they swallowed 5 ml of water. The results were compared with those assessed using the functional oral intake scale to decide the best cut-off point for detecting tube-feeding-dependent dysphagia. The intraclass correlation coefficient (ICC) of the 20 children in the control group was calculated to evaluate the intra-rater and inter-rater reliability of SUS. Results The average tongue muscle thickness change and hyoid bone displacement amplitude of the children on nasal feeding were significantly smaller than those of the children without nasal feeding and the normal children. The best cut-off point for the tongue muscle thickness change data was 1.0 cm, and that of the hyoid bone displacement amplitude was 1.5 cm. All of the ICCs were above 0.4, indicating good intra-rater and inter-rater reliability for the SUS examination. Conclusion Submental ultrasonongraphy can help assess the swallowing function of children with oropharyngeal swallowing disorders. Key words: Cerebral palsy; Assessment; Dysphagia; Submental ultrasonography; Ultrasound