A novel dysphagia screening method using panoramic radiography

Abstract

The purpose of this study was to establish a screening method for dysphagia using panoramic radiography. Seventy patients who had undergone panoramic radiography and videofluorographic swallowing study（VF）were selected. Exclusion criteria were surgery related to tumors, jaw deformity, and poor-quality panoramic radiograph images. Patients were diagnosed with dysphagia based on VF findings and accordingly categorized into Dysphagia（＋）or Dysphagia（−）groups. The control group consisted of 129 individuals who had undergone panoramic radiography for dental treatment. Exclusion criteria were the same as in the Dysphagia（＋）and Dysphagia（−）groups. Two maxillofacial radiologists assessed the vertical and horizontal position of the hyoid bone and measured the distance from the tongue to the palate. The vertical hyoid bone position was significantly lower in the Dysphagia（＋）group than in the control group. The distance from the tongue to the palate was significantly shorter in the control group, measuring 8.5±5.9mm as compared to 15.0±9.5 in the Dysphagia（＋）group and 14.9±10.0 in the Dysphagia（−）group. At least 77％ of patients were diagnosed with dysphagia or suspected of dysphagia because the hyoid body was below the mandibular line on panoramic radiography. Panoramic radiography may be a useful tool for predicting the risk of dysphagia as it reveals the vertical hyoid bone position and the distance from the tongue to the palate.