Association of tongue-hyoid bone motion parameters measured dynamically by submental ultrasound with the severity of post-stroke dysphagia.

BACKGROUND

Post-Stroke Dysphagia (PSD) is a common complication after stroke. An efficient, noninvasive assessment method is especially crucial for dysphagia. Submental ultrasound is an emerging noninvasive method for evaluating swallowing, enabling dynamic, real-time monitoring of the movements of the tongue and hyoid bone methods.

METHODS

This was a cross-sectional, single-center, observational study involving 213 stroke patients admitted to the department of rehabilitation between June 2023 and June 2024. All patients underwent assessment using the Penetration-Aspiration Scale (PAS) via videofluoroscopic swallowing study or flexible endoscopic evaluation of swallowing. All patients' tongue-hyoid bone movement parameters, such as hyoid bone displacement, hyoid bone displacement/resting distance ratio, geniohyoid muscle movement speed, and tongue muscle movement speed, were measured by submental ultrasound.

FINDINGS: The Aspiration and Penetration group had smaller hyoid bone displacement and slower geniohyoid and tongue muscle movement. All of these differences were statistically significant (P < 0.001). The predictive model for assessing the risk of severe-PSD (PAS 6-8 grade) achieved an area under the receiver operating characteristic curve of 0.927 (95% CI: 0.886-0.967). All tongue-hyoid bone movement parameters showed negative correlations with PAS grading when PAS was used as a continuous variable.

INTERPRETATION: Parameters related to hyoid bone movement and geniohyoid muscle velocity serve as key indicators of PSD severity. Submental ultrasound measurement of tongue-hyoid motion parameters demonstrates excellent assessment and predictive value for PSD severity, warranting clinical implementation.