Effect of Bolus Volume on Hyoid Movement in Normal Individuals

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  • UEDA Nami
    Division for Oral and Facial Disorders, Osaka University Dental Hospital
  • NOHARA Kanji
    Division for Oral and Facial Disorders, Osaka University Dental Hospital
  • KOTANI Yasuko
    Heisei Dental Clinic, Miwakai Medical Corporation
  • SAKAI Takayoshi
    Division for Functional Oral Neuroscience, Osaka University, Graduate School of Dentistry

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  • 一回嚥下量の変化が嚥下時の舌骨運動に与える影響について

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Abstract

<p>Purpose:　It has been reported that larger bolus volumes tend to increase the risk of aspiration. The hyoid bone moves during swallowing due to contraction of the suprahyoid muscles, which are critical components of normal swallowing function. Hyoid movement is important for epiglottic closure for airway protection and opening of the upper esophageal sphincter. It has been reported that the muscle force and shortening velocity decline gradually with age. Reduced hyoid velocity may delay the sealing of the laryngeal vestibule and opening of the cricopharyngeal muscle. We hypothesized that the displacement and velocity of hyoid movement could be factors influencing aspiration during swallowing. This study evaluated the effects of bolus volume changes on the displacement and velocity of hyoid movement in normal swallowing.</p><p>Method(s):　The subjects were 21 healthy young adults. Lateral projection videofluorography was recorded twice while each subject swallowed 2.5 ml, 5 ml, 10 ml and 20 ml of thin liquid barium in one gulp. The movements were measured in two directions, vertical and horizontal. The horizontal axis was defined by Camper’s plane. We evaluated the maximum displacement (Max d), upward displacement (Max ud), and forward displacement (Max fd) of hyoid movement during swallowing. We also evaluated the maximum velocity (Max v), upward velocity (Max uv), and forward velocity (Max fv) of hyoid movement during swallowing.</p><p>Results:　The two-way ANOVA test revealed that Max d, Max ud and Max fd for different bolus volumes are not significant different (Max d: 2.5 ml 20.3±3.6, 5 ml 20.3±3.4, 10 ml 20.4±3.8, 20 ml 20.3±3.8 (mm), Max ud: 2.5 ml 16.9±3.8, 5 ml 16.8±4.2, 10 ml 16.4±4.2, 20 ml 16.1±3.9 (mm), Max fd: 2.5 ml 15.5±3.6, 5 ml 15.4±2.8, 10 ml 15.9±3.3, 20 ml 14.6±4.5 (mm)). The two-way ANOVA test showed statistical significance in Max v, Max uv and Max fv among the different bolus volumes (p＜0.01) (Max v: 2.5 ml 49.9±9.3, 5 ml 51.6±9.0, 10 ml 55.0±12.1, 20 ml 63.4±12.8 (mm/s), Max uv: 2.5 ml 28.1±13.6, 5 ml 29.2±14.5, 10 ml 31.8±13.8, 20 ml 38.3±14.0 (mm/s), Max fv: 2.5 ml 44.5±9.5, 5 ml 47.5±9.5, 10 ml 48.7±9.8, 20 ml 53.4±10.9 (mm/s)). Tukey’s test showed significant differences in Max v between 2.5 and 20 ml, 5.0 and 20 ml, 10 and 20 ml, and 2.5 and 10 ml swallowing. Tukey’s test also showed significant differences in Max uv and fv between 2.5 and 20 ml, 5.0 and 20 ml, 10 and 20 ml swallowing.</p><p>Conclusion:　It is possible that a larger bolus volume requires greater maximum velocity of the hyoid movement. We plan to study the maximum velocity of hyoid movement in elderly subjects and in those with dysphagia.</p>

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