University College London Hospitals NHS Foundation Trust, National Hospital for Neurology & Neurosurgery.
National Centre for Airway Reconstruction, Department of Otolaryngology, Head and Neck Surgery, Imperial College Healthcare NHS Trust.
Curr Opin Otolaryngol Head Neck Surg. 2021 Jun 1;29(3):213-218. doi: 10.1097/MOO.0000000000000708.
Videofluoroscopy (VFSS) and fibreoptic endoscopic evaluation of swallowing (FEES) are established instrumental techniques to support differential diagnosis and treatment of oropharyngeal dysphagia. Whilst their value is undisputed, each tool is not without limitations. The COVID-19 pandemic has restricted access to VFSS and FEES leading clinicians to explore alternative or augmentative tools to support swallowing assessment.Ultrasound (US) is an established tool for visualisation of head and neck anatomy, including structures implicated in swallowing. Although US has been utilised in swallowing research for many years, its application has not translated into common clinical practice. This review presents and debates the evidence for and against use of US for clinical swallowing assessment.
Evaluation of swallowing muscle morphometry and measurement of isolated swallowing kinematics are two primary uses of US in swallowing assessment that have been identified in the literature. Use of US to detect bolus flow, aspiration and residues is in its early stages and needs further research.
US shows promise as an adjunctive modality to support assessment of swallowing. With standardisation, these measurements may have potential for transition into clinical care. Reliability and validity testing and development of normative data are imperative to ensure its use as an evidence-based instrumentation.
荧光透视吞咽功能检查（VFSS）和纤维内镜吞咽功能检查（FEES）是支持口咽吞咽障碍鉴别诊断和治疗的既定仪器技术。虽然它们的价值是毋庸置疑的，但每种工具都不是没有局限性的。COVID-19 大流行限制了 VFSS 和 FEES 的使用，导致临床医生探索替代或补充工具来支持吞咽评估。超声（US）是头颈部解剖结构可视化的既定工具，包括与吞咽有关的结构。尽管 US 多年来一直用于吞咽研究，但它的应用并没有转化为常见的临床实践。这篇综述介绍并讨论了 US 用于临床吞咽评估的利弊证据。
吞咽肌肉形态测量和孤立吞咽运动学的测量是 US 在吞咽评估中的两个主要用途，这在文献中已经得到了证实。使用 US 检测食团流动、吸入和残留仍处于早期阶段，需要进一步研究。
US 有望成为一种辅助手段，支持吞咽评估。随着标准化，这些测量可能有潜力转化为临床护理。可靠性和有效性测试以及正常数据的开发对于确保其作为基于证据的仪器的使用至关重要。
