Assessment of Oropharyngeal Dysphagia in Patients With Parkinson Disease: Use of Ultrasonography

OBJECTIVE: To compare tongue thickness, the shortest hyoid-thyroid approximation (distance between the hyoid bone and thyroid cartilage), and the time interval between the initiation of tongue movement and the time of the shortest hyoid-thyroid approximation, by using ultrasonography in healthy controls and patients with Parkinson disease (PD). METHODS: Healthy controls and PD patients with dysphagia were compared. Ultrasonography was performed 3 times for the evaluation of tongue thickness, the shortest hyoid-thyroid approximation, and the time between the initiation of tongue movement and the shortest hyoid-thyroid approximation. RESULTS: A total of 24 healthy controls and 24 PD patients with dysphagia were enrolled. No significant differences were demonstrated between the two groups for the shortest hyoid-thyroid approximation (controls, 1.19±0.34 cm; PD patients, 1.37±0.5 cm; p=0.15) and tongue thickness (controls, 4.42±0.46 cm; PD patients, 4.27±0.51 cm; p=0.3). In contrast, the time to the shortest hyoid-thyroid approximation was significantly different between the two groups (controls, 1.53±0.87 ms; PD patients, 2.4±1.4 ms, p=0.048). CONCLUSION: Ultrasonography can be useful in evaluating dysphagia in patients with PD by direct visualization and measurement of the hyoid bone. Moreover, ultrasonography might contribute to a greater understanding of the pathophysiology of dysphagia in PD.

Ultrasonographic Findings of Superficial Radial Nerve and Cephalic Vein

OBJECTIVE: To investigate the anatomic relationship between the superficial radial nerve (SRN) and the cephalic vein (CV) through ultrasonography due to the possibility of SRN injury during cephalic venipuncture. METHODS: Both forearms of 51 healthy volunteers with no history of trauma or surgery were examined in proximal to distal direction using ultrasonography. We measured the distance between the radial styloid process (RSP) and the point where the SRN begins contact with the CV, and measured the distance between the RSP and the point where the SRN is separated from the CV. The point where the SRN penetrates the brachioradialis fascia was also evaluated. RESULTS: The SRN came in contact with the CV at a mean of 9.35+/-1.05 cm from the RSP and separated from the CV at a mean of 6.29+/-1.17 cm from the RSP. The SRN pierced the brachioradialis fascia at a mean of 10.31+/-0.89 cm from the RSP and horizontally 1.35+/-0.36 cm medial to the radius margin. All parameters had no significant differences in gender or direction. CONCLUSION: The SRN had close approximation to the CV in the distal second quarter of the forearm. We recommend for cephalic venipuncture to be avoided in this area, and, if needed, it should be carried out with care not to cause injury to the SRN.