Skip to main content

Advertisement

SpringerLink
Log in

Hyoid bone displacement as parameter for swallowing impairment in patients treated for advanced head and neck cancer

  • Review Article
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Reduced hyoid displacement is thought to contribute to aspiration and pharyngeal residues in head and neck cancer (HNC) patients with dysphagia. To further study hyoid elevation and anterior excursion in HNC patients, this study reports on temporal/kinematic measures of hyoid displacement, with the additional goal to investigate correlations with clinical swallowing impairment. A single-blind analysis of data collected as part of a larger prospective study was performed at three time points before and after chemoradiotherapy. Twenty-five patients had undergone clinical swallowing assessments at baseline, 10-weeks, and 1-year post-treatment. Analysis of videofluoroscopic studies was done on different swallowing consistencies of varying amounts. The studies were independently reviewed frame-by-frame by two clinicians to assess temporal (onset and duration) and kinematic (anterior/superior movement) measures of hyoid displacement (ImageJ), laryngeal penetration/aspiration, and presence of vallecula/pyriform sinus residues. Patient-reported oral intake and swallowing function were also evaluated. Mean maximum hyoid displacement ranged from 9.4 mm (23 % of C2–4 distance) to 12.6 mm (27 %) anteriorly, and from 18.9 mm (41 %) to 24.9 mm (54 %) superiorly, depending on bolus volume and consistency. Patients with reduced superior hyoid displacement perceived significantly more swallowing impairment. No correlation between delayed or reduced hyoid excursion and aspiration or residue scores could be demonstrated. Hyoid displacement is subject to variability from a number of sources. Based on the results, this parameter seems not very valuable for clinical use in HNC patients with dysphagia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Perlman AL, VanDaele DJ, Otterbacher MS (1995) Quantitative assessment of hyoid bone displacement from video images during swallowing. J Speech Hear Res 38(3):579–585

    Article  CAS  PubMed  Google Scholar 

  2. Bingjie L, Tong Z, Xinting S, Jianmin X, Guijun J (2010) Quantitative videofluoroscopic analysis of penetration-aspiration in post-stroke patients. Neurol India 58(1):42–47

    Article  PubMed  Google Scholar 

  3. Wang TG, Chang YC, Chen WS, Lin PH, Hsiao TY (2010) Reduction in hyoid bone forward movement in irradiated nasopharyngeal carcinoma patients with dysphagia. Arch Phys Med Rehabil 91(6):926–931

    Article  PubMed  Google Scholar 

  4. Steele CM, Bailey GL, Chau T, Molfenter SM, Oshalla M, Waito AA, Zoratto DC (2011) The relationship between hyoid and laryngeal displacement and swallowing impairment. Clin Otolaryngol 36(1):30–36

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Pearson WG Jr, Hindson DF, Langmore SE, Zumwalt AC (2013) Evaluating swallowing muscles essential for hyolaryngeal elevation by using muscle functional magnetic resonance imaging. Int J Radiat Oncol Biol Phys 85(3):735–740

    Article  PubMed  Google Scholar 

  6. Zu Y, Yang Z, Perlman AL (2011) Hyoid displacement in post-treatment cancer patients: preliminary findings. J Speech Lang Hear Res 54(3):813–820

    Article  PubMed  Google Scholar 

  7. Hutcheson KA, Lewin JS, Barringer DA, Lisec A, Gunn GB, Moore MW, Holsinger FC (2012) Late dysphagia after radiotherapy-based treatment of head and neck cancer. Cancer 118(23):5793–5799

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kim Y, McCullough GH (2010) Maximal hyoid excursion in poststroke patients. Dysphagia 25(1):20–25

    Article  PubMed  Google Scholar 

  9. Molfenter SM, Steele CM (2014) Kinematic and temporal factors associated with penetration-aspiration in swallowing liquids. Dysphagia 29(2):269–276

    Article  PubMed  PubMed Central  Google Scholar 

  10. Steele CM, Cichero JA (2014) Physiological factors related to aspiration risk: a systematic review. Dysphagia 29(3):295–304

    Article  PubMed  PubMed Central  Google Scholar 

  11. Logemann JA, Pauloski BR, Rademaker AW, Colangelo LA, Kahrilas PJ, Smith CH (2000) Temporal and biomechanical characteristics of oropharyngeal swallow in younger and older men. J Speech Lang Hear Res 43(5):1264–1274

    Article  CAS  PubMed  Google Scholar 

  12. Kendall KA, Leonard RJ (2001) Hyoid movement during swallowing in older patients with dysphagia. Arch Otolaryngol Head Neck Surgery 127(10):1224–1229

    Article  CAS  Google Scholar 

  13. Logemann JA, Pauloski BR, Rademaker AW, Kahrilas PJ (2002) Oropharyngeal swallow in younger and older women: videofluoroscopic analysis. J Speech Lang Hear Research 45(3):434–445

    Article  Google Scholar 

  14. Kim Y, McCullough GH (2008) Maximum hyoid displacement in normal swallowing. Dysphagia 23(3):274–279

    Article  PubMed  Google Scholar 

  15. Paik NJ, Kim SJ, Lee HJ, Jeon JY, Lim JY, Han TR (2008) Movement of the hyoid bone and the epiglottis during swallowing in patients with dysphagia from different etiologies. J Electromyogr Kinesiol 18(2):329–335

    Article  PubMed  Google Scholar 

  16. Dodds WJ, Man KM, Cook IJ, Kahrilas PJ, Stewart ET, Kern MK (1988) Influence of bolus volume on swallow-induced hyoid movement in normal subjects. AJR Am J Roentgenol 150(6):1307–1309

    Article  CAS  PubMed  Google Scholar 

  17. Nagy A, Molfenter SM, Peladeau-Pigeon M, Stokely S, Steele CM (2014) The effect of bolus volume on hyoid kinematics in healthy swallowing. BioMed Res Int 2014:738971

    PubMed  PubMed Central  Google Scholar 

  18. Sia I, Carvajal P, Carnaby-Mann GD, Crary MA (2012) Measurement of hyoid and laryngeal displacement in video fluoroscopic swallowing studies: variability, reliability, and measurement error. Dysphagia 27(2):192–197

    Article  PubMed  Google Scholar 

  19. Baijens L, Barikroo A, Pilz W (2013) Intrarater and interrater reliability for measurements in videofluoroscopy of swallowing. Eur J Radiol 82(10):1683–1695

    Article  PubMed  Google Scholar 

  20. Molfenter SM, Steele CM (2011) Physiological variability in the deglutition literature: hyoid and laryngeal kinematics. Dysphagia 26(1):67–74

    Article  PubMed  Google Scholar 

  21. Lal PT, Verma A, Maria Das KP, Baijal SS, Bajpai R, Kumar P, Srivastava A, Kumar S (2009) Role of videofluorography in assessing functional abnormalities in patients of head and neck cancer treated with chemoradiotherapy. Asia Pacific J Clin Oncol 5(5):264–269

    Article  Google Scholar 

  22. van der Molen L, Heemsbergen WD, de Jong R, van Rossum MA, Smeele LE, Rasch CR, Hilgers FJ (2013) Dysphagia and trismus after concomitant chemo-Intensity-Modulated Radiation Therapy (chemo-IMRT) in advanced head and neck cancer; dose-effect relationships for swallowing and mastication structures. Radiother Oncol 106(3):364–369

    Article  PubMed  Google Scholar 

  23. van der Molen L, van Rossum MA, Burkhead LM, Smeele LE, Rasch CR, Hilgers FJ (2011) A randomized preventive rehabilitation trial in advanced head and neck cancer patients treated with chemoradiotherapy: feasibility, compliance, and short-term effects. Dysphagia 26(2):155–170

    Article  PubMed  Google Scholar 

  24. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL (1996) A penetration-aspiration scale. Dysphagia 11(2):93–98

    Article  CAS  PubMed  Google Scholar 

  25. Logemann JA (1997) Evaluation and treatment of swallowing disorders, 2nd edn. Pro-ed, ISBN-10:0890797285, ISBN-13:978-0890797280, p 406

  26. Pauloski BR, Rademaker AW, Logemann JA, Stein D, Beery Q, Newman L, Hanchett C, Tusant S, MacCracken E (2000) Pretreatment swallowing function in patients with head and neck cancer. Head Neck 22(5):474–482

    Article  CAS  PubMed  Google Scholar 

  27. Kendall KA, McKenzie S, Leonard RJ, Goncalves MI, Walker A (2000) Timing of events in normal swallowing: a videofluoroscopic study. Dysphagia 15(2):74–83

    Article  CAS  PubMed  Google Scholar 

  28. Leonard RJ, Kendall KA, McKenzie S, Goncalves MI, Walker A (2000) Structural displacements in normal swallowing: a videofluoroscopic study. Dysphagia 15(3):146–152

    Article  CAS  PubMed  Google Scholar 

  29. Leonard R, Kendall C (1997) Dysphagia assessment and treatment planning: a team approach, 1st edn. Singular, ISBN-10:156593749X, ISBN-13:978-1565937499, p 320

  30. van der Molen L, van Rossum MA, Ackerstaff AH, Smeele LE, Rasch CR, Hilgers FJ (2009) Pretreatment organ function in patients with advanced head and neck cancer: clinical outcome measures and patients’ views. BMC Ear Nose Throat Disord 9:10

    Article  PubMed  PubMed Central  Google Scholar 

  31. van der Kruis JG, Baijens LW, Speyer R, Zwijnenberg I (2011) Biomechanical analysis of hyoid bone displacement in videofluoroscopy: a systematic review of intervention effects. Dysphagia 26(2):171–182

    Article  PubMed  Google Scholar 

  32. Kraaijenga SA, van der Molen L, Jacobi I, Hamming-Vrieze O, Hilgers FJ, van den Brekel MW (2015) Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises. Eur Arch Otorhinolaryngol 272(11):3521–3531

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Sophie A. C. Kraaijenga, Lisette van der Molen, Gawein B. Remmerswaal, Frans J. M. Hilgers & Michiel W. M. van den Brekel

  2. Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Wilma D. Heemsbergen

  3. Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Wilma D. Heemsbergen

  4. Institute of Phonetic Sciences, University of Amsterdam, Amsterdam, The Netherlands

    Frans J. M. Hilgers & Michiel W. M. van den Brekel

  5. Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands

    Michiel W. M. van den Brekel

Authors
  1. Sophie A. C. Kraaijenga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisette van der Molen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wilma D. Heemsbergen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gawein B. Remmerswaal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Frans J. M. Hilgers
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michiel W. M. van den Brekel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michiel W. M. van den Brekel.

Ethics declarations

Conflict of interest

This study was made possible by Grants provided by Atos Medical (Sweden), the Verwelius Foundation (The Netherlands), and “Stichting de Hoop” (The Netherlands).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Appendix I: Selection of the translated Dutch study-specific questionnaire

Appendix I: Selection of the translated Dutch study-specific questionnaire

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kraaijenga, S.A.C., van der Molen, L., Heemsbergen, W.D. et al. Hyoid bone displacement as parameter for swallowing impairment in patients treated for advanced head and neck cancer. Eur Arch Otorhinolaryngol 274, 597–606 (2017). https://doi.org/10.1007/s00405-016-4029-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-016-4029-y

Keywords

Search

Navigation