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Ultrasound Imaging and Swallowing

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Normal and Abnormal Swallowing

Abstract

Ultrasound technology has advanced substantially, providing clinicians and researchers with vastly expanded noninvasive opportunities to study the dynamics of the oral pharyngeal system and the muscles and other soft tissues of the oropharynx during swallowing. In the current climate of cost containment and efficiency, ultrasound imaging presents a viable alternative to videofluorography to examine the oropharyngeal swallow. Because ultrasound imaging is uniquely suited for investigating soft tissue structures, it is used to view the abdomen, fetus, heart, bladder, genitalia, breast, and to visualize tumors and masses throughout the body (1–3). Ultrasound can be used to identify normal and abnormal oropharyngeal tissues such as the thyroid and salivary glands, tongue, palate, and floor of the mouth in various diseases, infections, and genetic conditions (4,5). Because of its inherent advantages (Table 8.1), ultrasound has been successfully adapted for viewing the oral cavity during swallowing (6–9). Real-time ultrasound is totally noninvasive, dynamic, and has no known bioeffects and minimal risk to the patient. Studies can therefore be performed repeatedly or for extended periods of time without risk of future tissue change from effects of long-term radiation. This property is especially relevant when one is studying infants and children who are at greater risk than adults for showing the cumulative effects of ionizing radiation. The air interface at the surface of the tongue is a nearly perfect reflector of sound, thus clearly displaying the lingual musculature and vessels both at rest and during oral motion. Ultrasound imaging is ideally suited to identifying the various soft tissues that compose the upper aerodigestive tract. In addition, the transduction properties of sound waves allow these soft tissues to be distinguished from ingested fluids, semisolids, and solid materials. Since no contrast material is needed to visualize the oropharynx and the bolus during swallowing, any type of food commonly ingested by the patient can be used during a study. The ultrasound examination is conducted with the adult or child patient seated in a comfortable position, while an infant is held on the mother’s lap. All ultrasound systems are portable, have built-in video systems, online computerized image processing and measurement programs, a computer keyboard, display screen, and hard copy printout capacity. Ultrasound is easy to use and provides reliable diagnostic information. Because of these advantages, ultrasound technology is well suited to evaluate individuals of any age from infancy to senescence, and any neurological, systemic, genetic, traumatic, developmental, or progressive condition that affects oral physiology.

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References

  1. Heckmatt JZ, Pier N, Dubowitz V. Real-time ultrasound imaging of muscles. Muscle Nerve 1988; 11: 56–65.

    Article  PubMed  CAS  Google Scholar 

  2. Fischer AQ, Carpenter DW, Hartlage PL, Carroll JE, Stephens S. Muscle imaging in neuromuscular disease using computerized real-time sonography. Muscle Nerve 1988; 11: 270–275.

    Article  PubMed  CAS  Google Scholar 

  3. Ishikawa H, Ishill F, et al. Evaluation of grayscale ultrasonography in the investigation of oral and neck mass lesions. J Oral Maxillofac Surg 1983; 41: 775–781.

    Article  PubMed  CAS  Google Scholar 

  4. Garel C, Elmaleh M, Francois M, Narcy P, Hassan M. Ultrasonographic evaluation of the tongue and the floor of the mouth: normal and pathological findings. Pediatr Radiol 1994; 24: 554–557.

    Article  PubMed  CAS  Google Scholar 

  5. Ueda D, Yano K, Okuno A. Ultrasonic imaging of the tongue, mouth, and vocal cords in normal children—establishment of basic scanning positions. J Clin Ultrasound 1993; 21: 431–439.

    Article  PubMed  CAS  Google Scholar 

  6. Shawker TH, Sonies B, Stone M, Baum BJ. Real-time ultrasound visualization of tongue movement during swallowing. J Clin Ultrasound 1983; 11: 485–490.

    Article  PubMed  CAS  Google Scholar 

  7. Shawker TH, Sonies B, Hall TE, Baum BF. Ultrasound analysis of tongue, hyoid, and larynx activity during swallowing. Invest Radiol 1984; 19: 82–86.

    Article  PubMed  CAS  Google Scholar 

  8. Shawker TH, Stone M, Sonies BC. Sonography of speech and swallow. In: Sanders RC, Hill MC, eds. Ultrasound Annual. New York: Raven Press; 1984: 237–260.

    Google Scholar 

  9. Shawker TH, Sonies BC, Stone M. Soft-tissue anatomy of the tongue and floor of the mouth— an ultrasound demonstration. Brain Lang 1984; 21: 335–350.

    Article  PubMed  CAS  Google Scholar 

  10. Gritzman N, Fruhwald F. Sonographic anatomy of tongue and floor of the mouth. Dysphagia 1988; 3: 196–202.

    Article  Google Scholar 

  11. Watkin KL, Miller JL. 3D ultrasonic imaging of the tongue-volume rendering, surface modeling and volume estimation [abstract]. Dysphagia 1997; 12: 108.

    Google Scholar 

  12. Hedrick WR, Hykes DL, Starchman DE. Ultrasound Physics and Instrumentation. St. Louis, MO: CV Mosby; 1995.

    Google Scholar 

  13. Keneko T, Numata T, Suzuki H, Hino T, Komatsu K, MasudaT. Newly developed ultrasound laryn-gographic equipment and its clinical application. In: Fujimura D, ed. Social Physiology: Voice Production, Mechanism and Function. New York: Raven Press; 1988: 271–278.

    Google Scholar 

  14. Raghavendra BN, Horri SC, Reede DL, Rumancik WM, Persky M, Bergeron T. Sonographic anatomy of the larynx with particular reference to the vocal cords. J Ultrasound Med 1987; 6: 225–230.

    PubMed  CAS  Google Scholar 

  15. Sonies BC, Wang C, Sapper DJ. Evaluation of normal and abnormal hyoid bone movement during swallowing by use of ultrasound duplex- Doppler imaging. Ultrasound Med Biol 1996; 22: 1169–1175.

    Article  PubMed  CAS  Google Scholar 

  16. Watkin KL, Miller JL. Instrumental imaging technologies and procedures. In: Sonies BC, ed. Dysphagia: A Continuum of Care. Gaithersburg, MD: Aspen Publishers; 1997: 171–196.

    Google Scholar 

  17. Miller JL, Watkin KL. Color flow Doppler ultrasound of lingual hemodynamics: a preliminary study [abstract]. Dysphagia 1996; 11: 158.

    Article  Google Scholar 

  18. Miller JL, Watkin KL. Color flow Doppler US of lingual vascularization in postoperative oral cancer subjects [abstract]. Dysphagia 1997; 2: 114.

    Google Scholar 

  19. Hamlet SL, Stone M, Shawker T. Posterior tongue grooving in deglutition and speech: preliminary observations. Dysphagia 1988; 3: 65–68.

    Article  PubMed  CAS  Google Scholar 

  20. Sonies BC, Parent L, Morrish K, Baum BJ. Durational aspects of the oral-pharyngeal swallow in normal adults. Dysphagia 1988; 3: 1–10.

    Article  PubMed  CAS  Google Scholar 

  21. Chi-Fishman G, Stone M, McCall GN. Lingual action in normal sequential swallowing. J Speech, Lang Hear Res 1998; 41: 771–785.

    CAS  Google Scholar 

  22. Chi-Fishman G. Tongue-Palate Interaction in Discrete and Sequential Swallowing. Dissertation Abstracts International 1997;58: 01B (University Microfilms No. 97197241.

    Google Scholar 

  23. Morrish KA, Stone M, Shawker TH, Sonies BC. Distinguishability of tongue shape during vowel production. J Phonet 1985; 13: 189–203.

    Google Scholar 

  24. Stone M, Sonies BC, Shawker TH, Weiss G, Nadel L. Analysis of real-time ultrasound images of tongue configuration using a grid-digitizing system. J Phonet 1983; 11: 207–218.

    Google Scholar 

  25. Stone M, Shawker T. An ultrasound examination of tongue movement during swallowing. Dysphagia 1986; 1: 78–83.

    Article  PubMed  CAS  Google Scholar 

  26. Sonies BC, Stone M, Shawker T. Speech and swallowing in the elderly. J Gerodontol 1984; 3: 115–123.

    Article  CAS  Google Scholar 

  27. Caruso AJ, Sonies BC, Atkinson JC, Fox PC. Objective measures of swallowing in patients with primary Sjogren’s syndrome. Dysphagia 1989; 4: 101–105.

    Article  PubMed  CAS  Google Scholar 

  28. Sonies BC, Dalakas MC. Progression of oral-motor and swallowing symptoms in the post-polio syndrome. Ann NY Acad Sei 1995; 753: 87–95.

    Article  CAS  Google Scholar 

  29. Siegel H, Sonies BC, Graham B, et al. Obstructive sleep apnea: a study by simultaneous polysomnography and ultrasound imaging. Neurology 2000; 54 (9): 1872.

    Article  PubMed  CAS  Google Scholar 

  30. Watkin KL, Miller JL. Lateral pharyngeal wall motion during swallowing: analysis of B/M- mode ultrasound imaging [abstract]. Dysphagia 1996; 11: 161.

    Google Scholar 

  31. Miller JL, Watkin KL. Lateral pharyngeal wall motion during swallowing using real time ultrasound. Dysphagia 1997; 12: 125–132.

    Article  PubMed  CAS  Google Scholar 

  32. Smith WL, Erenberg A, Nowak A, Franken EA. Physiology of sucking in the normal term infant using real-time US. Radiology 1985; 156: 379–381.

    PubMed  CAS  Google Scholar 

  33. Weber F, Woolridge MW, Baum JD. An ultrasonographic study of the organization of sucking and swallowing by newborn infants. Dev Med Child Neurol 1986; 28: 19–24.

    Article  PubMed  CAS  Google Scholar 

  34. Bosma JF, Hepburn LG, Josell SD, Baker K. Ultrasound demonstration of tongue motions during suckle feeding. Dev Med Child Neurol 1990; 32: 223–229.

    Article  PubMed  CAS  Google Scholar 

  35. Bosma JF. Development and impairments of feeding in infancy and childhood. In: Groher ME, ed. Dysphagia Diagnosis and Management. ( 2nd ed. ). Boston: Butterworth-Heinemann; 1992: 107–142.

    Google Scholar 

  36. Bullock F, Woolridge MW, Baum JD. Development of co-ordination of sucking, swallowing and breathing: ultrasound study of term and preterm infants. Dev Med Child Neurol 1990; 32: 669–678.

    Article  Google Scholar 

  37. Lau C, Schanler J. Oral motor function in the neonate. Clin Perinatol 1996; 23: 161–178.

    PubMed  CAS  Google Scholar 

  38. Nowak A J, Smith WL, Erenberg A. Imaging evaluation of artificial nipples during bottle feeding. Arch Pediatr Adolesc Med 1994; 148: 40–42.

    Article  PubMed  CAS  Google Scholar 

  39. Nowak AJ, Smith WL, Erenberg A. Imaging evaluation of breast-feeding and bottle-feeding systems./Pediatr 1995; 126: S130 - S134.

    CAS  Google Scholar 

  40. Smith WL, Erenberg A, Nowak A. Imaging evaluation of the human nipple during breastfeeding. Am J Dis Child 1988; 142: 76–78.

    PubMed  CAS  Google Scholar 

  41. Thach BT, Stark AR. Spontaneous neck flexion and airway obstruction during apneic spells in preterm infants. J Pediatr 1979; 95: 26–54.

    Google Scholar 

  42. Sonies BC, Solomon BI, Miller JL. Pediatric ultrasound. Paper presented at: American Speech-Language and Hearing Association Annual Convention; 1996; Seattle.

    Google Scholar 

  43. Humphrey T. Reflex activity in the oral and facial area of the human fetus. In: Bosma JF, ed. Oral Sensation and Perception: Second Symposium. Springfield, IL: Charles C Thomas Publisher; 1970: 195–233.

    Google Scholar 

  44. Ianniruberto A, Tajani E. Ultrasonographic study of fetal movements. Semin Perinatol 1981; 5: 175–181.

    PubMed  CAS  Google Scholar 

  45. Sonies BC, Miller JL, Macedonia C. Ultrasound evaluation of the development of the fetal upper aerodigestive tract: establishing clinical indicators of deglutitive function. 2000; unpublished raw data.

    Google Scholar 

  46. Sonies BC, Gottlieb E, Solomon BI, Matthews K, Huckabee ML. Simultaneous ultrasound and EMG study of swallowing [abstract]. Dysphagia 1997; 12: 106.

    Article  Google Scholar 

  47. Casas MJ, Kenny DJ, McPherson K. Swallowing/ventilation interactions during oral swallow in normal children and children with cerebral palsy. Dysphagia 1994; 9: 40–46.

    Article  PubMed  CAS  Google Scholar 

  48. Casas MJ, McPherson KA, Kenny DJ. Durational aspects of oral swallow in neurologically normal children and children with cerebral palsy—an ultrasound investigation. Dysphagia 1995; 10: 155–159.

    Article  PubMed  CAS  Google Scholar 

  49. Kenny DJ, Casas MJ, McPherson KA. Correlation of ultrasound imaging of oral swallow with ventilatory alterations in cerebral palsied and normal children: preliminary observations. Dysphagia 1989; 4: 112–117.

    Article  PubMed  CAS  Google Scholar 

  50. Selley WG, Ellis RE, Flack FC, Brooks WA. Coordination of sucking, swallowing and breathing in the newborn: its relationship to infant feeding and normal development. Br J Disord Commun 1990; 25: 311–327.

    Article  PubMed  CAS  Google Scholar 

  51. Wein B, Bockler R, Klajman S. Temporal reconstruction of sonographic imaging of disturbed tongue movements. Dysphagia 1991; 6: 135–139.

    Article  PubMed  CAS  Google Scholar 

  52. Smith SW, Pavy JG Jr, von Ramm OT. Highspeed ultrasound volumetric imaging system, I: transducer design and beam steering. IEEE Trans Ultrasonics, Ferro electrics, Frequency Control 1991; 38: 100–108.

    Article  CAS  Google Scholar 

  53. von Ramm OT, Smith SW, Pavy JG Jr. Highspeed ultrasound volumetric imaging system, II: parallel processing and image display. IEEE Trans Ultrason Ferroelectrics, Frequency Control 1991; 38: 109–115.

    Article  Google Scholar 

  54. Chi-Fishman G, Sonies BC, Ohazama CJ, Freidlin RZ. Real-time 3-D ultrasound imaging of lingual action during swallowing [abstract]. Dysphagia 2000; 15 (2): 106.

    Google Scholar 

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Authors
  1. Barbara C. Sonies
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  2. Gloria Chi-Fishman
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  3. Jeri L. Miller
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Editor information

Editors and Affiliations

  1. The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 21287, Baltimore, MD, USA

    Bronwyn Jones MD, FRACP, FRCR (Professor of Radiology, Director) (Professor of Radiology, Director)

  2. The Johns Hopkins Swallowing Center, 21287, Baltimore, MD, USA

    Bronwyn Jones MD, FRACP, FRCR (Professor of Radiology, Director) (Professor of Radiology, Director)

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© 2003 Springer Science+Business Media New York

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Sonies, B.C., Chi-Fishman, G., Miller, J.L. (2003). Ultrasound Imaging and Swallowing. In: Jones, B. (eds) Normal and Abnormal Swallowing. Springer, New York, NY. https://doi.org/10.1007/978-0-387-22434-3_8

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  • DOI: https://doi.org/10.1007/978-0-387-22434-3_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-2904-4

  • Online ISBN: 978-0-387-22434-3

  • eBook Packages: Springer Book Archive

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