Sonographic assessment of hyoid bone movement during swallowing: a study of normal adults with advancing age

Our aim in this study was to evaluate hyoid bone movement trajectories and the age-related changes during swallowing in healthy subjects by ultrasonography. Data were obtained from 30 healthy volunteers (15 men, 15 women) in three age groups (20-39, 40-59, 60-79 years). The subjects were examined while sitting in an upright position, with the back against a wall to control movement. The transducer was placed in a longitudinal scan above the larynx. The subjects were then given 5 mL of mineral water. The water bolus was held in their mouth until they were forced to do a rapid swallow. The imaging was repeated five times for averaging. The movement was divided into 4 phases: slowly ascending phase (A-B, Elevation); rapidly ascending phase (B-C, Anterior); temporary pause phase (position of maximum rise, Remain); and rapidly and slowly descending shifts toward the resting position phase (C-D, Return). We easily visualized the hyoid bone trajectory by using ultrasonography. In all cases, ultrasonographic analysis of the hyoid bone was confirmed to have a similar trajectory, as determined with videofluoroscopy. The average swallowing duration measurements increased with age. The measurement of the maximally elevated point of the hyoid bone decreased with age. The movement of the hyoid bone during swallowing can be visualized by US. The trajectory of the hyoid bone in sagittal section indicated the capability of swallowing, and may detect some anomalies in swallowing.