Computer-assisted assessment of hyoid bone motion from videofluoroscopic swallow studies

Videofluoroscopic examination of swallowing remains the standard for evaluation of patients with swallowing complaints. Although attempts have been made to objectify aspects of the study, findings from the study are largely subjective and reliant on clinician training and judgment leading to considerable inter-rater variability. We describe a computerized image analysis program designed to objectify one component of the swallow study, the movement of the hyoid bone. Hyoid motion has been shown to be different in dysphagic versus non-dysphagic patients. Reduced hyoid elevation is also considered a risk factor for aspiration; however, there has not been much work done on actually quantifying hyoid motion and associating it with other aspects of the swallow study. The clinician is prompted to define the hyoid bone in a calibration frame, and the system then tracks that region of interest throughout the rest of the study. This system shows strong correlations with manual analysis and can account for head position changes during the study. While the hyoid bone was reported on in this study, other regions of interest within the image field could also be tracked using this technique. A more quantitative analysis such as this has the opportunity to improve the inter-rater reliability of the test and therefore lead to more consistent findings from swallow studies.