Associations Between Ultrasonographic Hyoid Motion Parameters and Penetration, Aspiration, and Pharyngeal Residue Across International Dysphagia Diet Standardisation Initiative Food Textures

Purpose: The clinical swallow examination, including palpation of hyo-laryngeal motion, is an important screening technique for dysphagia. However, this method lacks objectivity and precision, and it cannot reliably quantify hyoid movement velocity, which may be more closely associated with the risk of penetration and aspiration. This prospective observational study aimed to evaluate the predictive value of ultrasonographic hyoid motion parameters for identifying penetration, aspiration, and pharyngeal residue across International Dysphagia Diet Standardisation Initiative (IDDSI) food textures. Method: Forty-seven adults with suspected oropharyngeal dysphagia underwent submental ultrasonography alongside either videofluoroscopic swallowing study or flexible endoscopic evaluation of swallowing. Six kinematic parameters, including hyoid displacement and velocity metrics, were measured and compared to instrumental swallowing outcomes. Results: Penetration and aspiration were most prevalent with thin liquids (IDDSI Level 0, 57.4%). At this consistency, reduced maximal hyoid displacement was significantly associated with higher Penetration–Aspiration Scale scores (odds ratio [ OR ] = 0.75, p = .036). In contrast, in the present study, vallecular residue showed stronger associations with the velocity-based parameters examined. At IDDSI Level 2, lower average velocity of anterior hyoid bone excursion (HBE; OR = 0.18, p = .036) and lower average velocity of maximal HBE ( OR = 0.24, p = .036) were associated with increased vallecular stasis severity. Similar associations were observed at Level 5, with area under the curve values up to .69. Pyriform sinus residue showed limited association with hyoid motion parameters. Receiver operating characteristic analysis and ordinal logistic regression demonstrated consistency-dependent associations between specific sonographic parameters and swallowing outcomes. Conclusions: Submental ultrasonography allows noninvasive quantification of hyoid motion during swallowing. Certain kinematic parameters demonstrated associations with airway invasion and vallecular residue at specific food consistencies. However, integration with complementary assessments remains essential for comprehensive evaluation. Supplemental Material: https://doi.org/10.23641/asha.32616798