Parâmetros de deslocamento do ossso hióide através da ultrassonografia em pacientes internados em UTI pós uso de ventilação mecânica

Abstract

This dissertation, structured into three articles, investigates the accuracy and clinical application of speech-language pathology ultrasonography (USG) in evaluating hyoid bone and thyroid cartilage displacement for diagnosing laryngeal penetration or tracheal aspiration risk. The literature review (Article 1), comprising 21 studies, confirmed the diagnostic potential of the method, but pointed out a scarcity of research in larger populations and a lack of standardization in measurement extraction. For method validation (Article 2), repeatability analysis between two sessions 24 hours apart demonstrated stability and longitudinal reproducibility (p > 0.05); furthermore, biomechanical mapping revealed that increased food viscosity requires greater structural excursion for airway protection, with yogurt eliciting the lowest mean approximation (0.48 cm; p = 0.001) and the highest absolute (p = 0.004) and relative (59.18%; p = 0.001) displacement compared to liquids and saliva. Finally, the clinical stage (Article 3), conducted with 42 ICU patients following prolonged mechanical ventilation (over 48 hours) and assessed 24 hours post-extubation, confirmed this biomechanical profile across consistencies, correlating hyoid displacement parameters with different degrees of dysphagia using the ASHA NOMS scale and oral intake functionality levels using the FOIS scale. [resumo fornecido pelo autor]