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Updated: Jun 19, 2026
Coordinate Mapping of Hyolaryngeal Mechanics in Swallowing
Published on: May 6, 2014
Geniohyoid muscle size is associated with respiratory complications after surgical treatment for traumatic cervical
Shizumasa Murata1, Keiji Nagata2, Yuyu Ishimoto2
1Department of Orthopedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama 641-8510, Japan; Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan.
Background Context:
Respiratory complications are common after traumatic cervical spinal cord injury (cSCI) and adversely affect early clinical outcomes. However, objective imaging-derived markers reflecting swallowing musculature reserve remain poorly studied in acute trauma.
Purpose:
To determine whether geniohyoid muscle size on admission cervical computed tomography (CT) is associated with 30-day respiratory complications after surgery for traumatic cSCI.
Design:
Retrospective single-center cohort study.
Patient Sample:
A total of 337 consecutive adults undergoing surgical decompression and/or stabilization for traumatic cSCI (2011-2024).
Outcome Measures:
A total of 30-day respiratory complications, defined as pneumonia, prolonged ventilation (>72 hours), or reintubation after planned extubation.
Methods:
Geniohyoid muscle cross-sectional area (GH-CSA) was measured on midsagittal admission CT by 2 independent assessors. Firth-penalized logistic regression was used, adjusting for prespecified demographic, neurological, comorbidity, injury-related, and surgical covariates. Incremental predictive value was assessed by comparing model performance with and without GH-CSA.
Results:
Respiratory complications occurred in 78/337 patients (23.1%). Lower GH-CSA was independently associated with higher odds of respiratory complications (adjusted odds ratio, 2.29 per 0.5-cm² decrease; 95% confidence interval, 1.86-2.99; p<.0001). The final model showed good discrimination (area under the curve [AUC], 0.86; 95% confidence interval, 0.82-0.91). Adding GH-CSA to American Society of Anesthesiologists class, American Spinal Injury Association Impairment Scale grade, and posterior spinal fusion improved discrimination (ΔAUC, +0.11).
Conclusions:
Smaller GH size on admission CT was independently associated with 30-day respiratory complications after surgery for traumatic cSCI. This marker may provide prognostic information beyond established predictors. External validation and prospective studies incorporating standardized swallowing assessment are warranted.
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