J Korean Dysphagia Soc.  2024 Jul;14(2):87-94. 10.34160/jkds.24.003.

Ultrasound Utilization in the Diagnosis and Management of Dysphagia

• Kim MW

• KMID: 2559387
• DOI: http://doi.org/10.34160/jkds.24.003

Abstract

Dysphagia, prevalent in stroke (51%-78%), Parkinson’s disease (80%-95%), ALS (80% in advanced stages), multiple sclerosis (31.3%), and dementia (13%-57%) patients, presents significant diagnostic challenges. Standard evaluation methods, such as VFSS and FEES, have limitations, including radiation exposure and patient discomfort. Ultrasound (US) offers a non-invasive, radiation-free alternative that allows a detailed observation of the airway, vocal cord movements, and cricopharyngeus, oral and submental muscles. This paper reviews the current research on US use in dysphagia, detailing anatomical landmarks and sonographic images for clinical applications. Key areas include the basic anatomy for US, hyolaryngeal movement, evaluation of aspiration and residue, an assessment and interventions of the upper esophageal sphincter, and an evaluation of the tongue and submental muscles. US can predict the severity of dysphagia by evaluating hyolaryngeal movement and identifying residue and aspiration, but precise quantification remains challenging. Observing the cricopharyngeal muscle with US enhances the accuracy of botulinum toxin injections. In addition, US measurements of the tongue and submental muscles aid in diagnosing conditions such as ALS. Standardizing US scanning and measurement protocols is crucial, and future advances in AI and 3D imaging technologies promise to improve accuracy in measuring complex movements and localizing anatomical structures.

Keyword

Dysphagia; Hyoid bone; Ultrasonography; Upper esophageal sphincter; Tongue