Application of Ultrasonography in Neurogenic Dysphagia: A Systematic Review

Abstract

Swallowing disorders are common in neurological diseases, with dysphagia representing one of the most prevalent complications that may cause poor quality of life, reduce independence, and increase mortality. Rapid identification of dysphagia is necessary to reduce the risk of penetration and aspiration, and to early start rehabilitation protocols. Among the methods that can be used to evaluate dysphagia and its components, ultrasound imaging has been suggested to support the evaluation of dysphagia by providing measures of both static and dynamic anatomical components. The aim of this systematic review is to evaluate the usefulness of ultrasonography in neurogenic dysphagia according to current literature. From 2000 to 2020, 633 studies with the appropriate search terms for ultrasound and dysphagia were identified. After screening them, 10 studies were included in the qualitative analysis. Patients with the following neurologic conditions were studied with ultrasonography for dysphagia: Parkinson’s disease, muscle dystrophy, amyotrophic lateral sclerosis, and stroke. The main outcomes of ultrasonography were swallowing muscles thickness (e.g., tongue), and dynamic measures such as hyoid displacement. The different protocols used in the studies, as well as their outcomes, did not allow to provide standard procedures and normative or cut-off values in the presented diseases. Because there are a variety of tools, methods, and techniques that have been used in the studies that were reviewed, it is difficult to evaluate them using established standards. However, ultrasonography correlates well with clinical evaluation of dysphagia and therefore has prognostic and rehabilitation potential. Future studies should aim to develop and utilize a common interdisciplinary protocol that includes standard procedures and outcomes to define normative values applicable in the different conditions.

Assessing Muscle Mass in the Orthopedic Clinical Setting: Application of the Ultrasound Sarcopenia Index in Elderly Subjects with a Recent Femoral Fracture

“…Even though there are plenty of tools for evaluating muscle mass in the clinical setting, these are often expensive and not practical, and for these reasons, they are scarcely used preoperatively [ 4 ]. Muscle ultrasound (US) has been suggested to be feasible in clinical practice, providing quantitative measures of muscle architecture in sports medicine, geriatrics, and other medical disciplines [ 5 , 6 , 7 , 8 , 9 ]. In 2003, Narici et al reported that the loss of muscle mass associated with sarcopenia entails not only a decrease in muscle cross-sectional area and volume but also alterations in the spatial arrangement of muscle fibers within the muscle [specifically, fiber fascicle length (Lf), pennation angle (θ), and muscle thickness (Tm)], known as “muscle architecture” [ 4 ].…”

Profile of oropharyngeal dysphagia patients in a teaching hospital in Northern Brazil: a descriptive cross-sectional study

“…In addition to dysphagia related to neurological disorders, there are other causes that occur due to different conditions, known as mechanical dysphagia, in which the anatomical structures responsible for swallowing suffer some structural damage, as occurs in head and neck cancers, cardiovascular diseases, lung diseases, and respiratory diseases 5 . When difficulty in swallowing is associated with respiratory diseases, there is a possibility of bronchoaspiration 6 , in which entry of food or fluids into the lower airways can generate pneumonia and death 7 .…”

“…When difficulty in swallowing is associated with respiratory diseases, there is a possibility of bronchoaspiration 6 , in which entry of food or fluids into the lower airways can generate pneumonia and death 7 . It is also known that the elderly are more susceptible to dysphagia due to the diseases, such as stroke and cardiovascular diseases, which accompany this condition 4 , 5 .…”