Swallowing Kinematic Analysis Might Be Helpful In Predicting Aspiration And Pyriform Sinus Stasis

Aspiration and pyriform sinus stasis resulting from compromised swallowing might cause aspiration pneumonia, which can have a negative impact on the patient’s prognosis. Clinically, videofluoroscopic swallow study (VFSS) is considered the standard instrument that is able to provide clues that contribute to the physiological impairment of swallowing. In addition, according to previously published literature, the parameters of kinematic analyses of VFSS might provide further information for aspiration detection. In this study, 449 files of VFSS studies from 232 patients were divided into three groups: normal, aspiration, and pyriform sinus stasis. Kinematic analyses and between-group comparison were conducted. Significant between-group differences were noted among parameters, including anterior hyoid displacement, maximal hyoid displacement, and average velocity of hyoid movement. No significant difference was detected in superior hyoid displacement. Furthermore, receiver-operating characteristic (ROC) analyses using anterior hyoid displacement, velocity of anterior hyoid displacement, and average velocity of maximal hyoid displacement showed acceptable predictability for detecting aspiration. Using 33.0 mm/s as a cutoff value of average velocity of maximal hyoid displacement, the sensitivity of detecting the presence of aspiration could be about 90%. Therefore, we assumed that the average velocity of maximal hyoid displacement could be a potential screening tool to detect aspiration.