A novel dysphagia screening method using panoramic radiography

Abstract

The purpose of this study was to establish a screening method for dysphagia using panoramic radiography. Seventy patients who had undergone panoramic radiography and videofluorographic swallowing study VF were selected. Exclusion criteria were surgery related to tumors, jaw deformity, and poor-quality panoramic radiograph images. Patients were diagnosed with dysphagia based on VF findings and accordingly categorized into Dysphagia or Dysphagia groups. The control group consisted of 129 individuals who had undergone panoramic radiography for dental treatment. Exclusion criteria were the same as in the Dysphagia and Dysphagia groups. Two maxillofacial radiologists assessed the vertical and horizontal position of the hyoid bone and measured the distance from the tongue to the palate. The vertical hyoid bone position was significantly lower in the Dysphagia group than in the control group. The distance from the tongue to the palate was significantly shorter in the control group, measuring 8.5 5.9 mm as compared to 15.0 9.5 in the Dysphagia group and 14.9 10.0 in the Dysphagia group. At least 77 of patients were diagnosed with dysphagia or suspected of dysphagia because the hyoid body was below the mandibular line on panoramic radiography. Panoramic radiography may be a useful tool for predicting the risk of dysphagia as it reveals the vertical hyoid bone position and the distance from the tongue to the palate.

A Basic Study for Predicting Dysphagia in Panoramic X-ray Images Using Artificial Intelligence (AI) Part 2: Analysis of the Position of the Hyoid Bone on Panoramic Radiographs

“…Oral frailty is a risk factor for physical frailty, and is related to quality of life. In previous studies [1,2], we suggested that patients with dysphagia have a lower position of the hyoid bone on panoramic radiographs. However, this anatomical structure did not focus on the dental treatment.…”

“…In our previous study, we concluded that the 43 patients diagnosed with dysphagia, 28 patients had either Type 0 or Type 1 hyoid bone position. We found that dysphagia was observed when the hyoid bone was positioned below the mandibular border line [2]. However, the hyoid bone is an anatomical structure that has received little attention in the literature concerning panoramic radiographs.…”

A Basic Study for Predicting Dysphagia in Panoramic X-ray Images Using Artificial Intelligence (AI)—Part 1: Determining Evaluation Factors and Cutoff Levels

“…Evaluation of the vertical hyoid bone position, the horizontal hyoid bone position, and the measurement of the distance from the tongue to the palate were performed according to the method of Ito et al [9]. The measurement and evaluation methods are shown below.…”

“…Figure 1 illustrates the evaluation of the vertical position of the hyoid bone and shows sample images. This method of measurement was as specified in Ito et al [9]. Figure 2 shows sample images.…”

“…Figure 3 illustrates how to evaluate the position of the horizontal hyoid bone and Figure 4 shows sample images. This method of measurement was taken from Ito et al [9]. The horizontal position of the hyoid bone was graded based on the anterior point of the hyoid body.…”