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Title: Utility of ultrasound in the assessment of swallowing and laryngeal function: A rapid review and critical appraisal of the literature
Austin Authors: Allen, Jodi E.;Clunie, Gemma M.;Slinger, Claire;Haines, Jemma;Mossey‐Gaston, Corinne;Zaga, Charissa J ;Scott, Becky;Wallace, Sarah;Govender, Roganie
Affiliation: National Hospital for Neurology & Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
National Centre for Airway Reconstruction, Department of Otolaryngology, Head and Neck Surgery, Imperial College Healthcare NHS Trust, London, UK
Department of Surgery and Cancer, Imperial College, London
Lancashire Teaching Hospitals, Preston, Lancashire, UK
NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
Wythenshawe Hospital Manchester University NHS Foundation Trust, Manchester, UK
Royal Papworth Hospital, Cambridge, UK
Department of Speech Pathology, Division of Allied Health, Austin Health, Melbourne, Victoria, Australia
Royal Papworth Hospital, Cambridge, UK
University College London Hospitals NHS Foundation Trust, London, UK
Head & Neck Academic Centre, University College London, London, UK
Issue Date: 2020
Publication information: Allen et al. Utility of ultrasound in the assessment of swallowing and laryngeal function: A rapid review and critical appraisal of the literature. International Journal of Language & Communication Disorders. 56(1) 174-204
Abstract: Background Ultrasound (US) is not widely used as part of the speech and language therapy (SLT) clinical toolkit. The COVID-19 pandemic has intensified interest in US as an alternative to SLT instrumental tools such as the videofluoroscopic swallowing study (VFSS), fibreoptic endoscopic evaluation of swallowing (FEES) and endoscopic evaluation of the larynx (EEL) as a non-invasive, non-aerosol-generating procedure that can be delivered at the bedside to assess swallowing and/or laryngeal function. To establish the appropriacy of routine US use, and in response to a national professional body request for a position statement, a group of expert SLTs conducted a rapid review of the literature. Aim To explore critically the clinical utility of US as an assessment tool for swallowing and laryngeal function in adults. Methods & Procedures A rapid review of four databases was completed to identify articles using US to assess swallowing and/or laryngeal function in adults compared with reference tests (VFSS/FEES/EEL/validated outcome measure). Screening was completed according to predefined inclusion/exclusion criteria and 10% of abstracts were rescreened to assess reliability. Data were extracted from full texts using a predeveloped form. The QUADAS-2 tool was used for quality ratings. Information from included studies was summarized using narrative synthesis and visual illustration. Outcomes & Results Ten papers used US to assess swallowing, and 13 to assess laryngeal function. All were peer-reviewed primary studies across a range of clinical populations and with a wide geographical spread. Four papers had an overall low risk of bias, but the remaining 19 had at least one domain where risk of bias was judged as high or unclear. Applicability concerns were identified in all papers. The papers that used US to assess swallowing varied widely in terms of the anatomical structures assessed and methodology employed. The papers assessing laryngeal function were more homogenous in their methodology. Sensitivity and specificity data were provided for 12 of the laryngeal function papers with ranges of 64.3–100% and 48.5–100%, respectively. Conclusions & Implications There is burgeoning evidence to support the use of US as an adjunct to SLT clinical assessment of swallowing and laryngeal function. However, the current literature does not support its use as a tool in isolation. Further research is required to establish reliability in US assessment as well as clear SLT-driven protocols and training.
DOI: 10.1111/1460-6984.12584
ORCID: 0000-0002-6717-908X
Type: Journal Article
Appears in Collections:Journal articles

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