Influence of craniofacial morphology on hyoid movement: A preliminary correlational study

Keith A. Mays, Jeffrey B. Palmer, Keith V. Kuhlemeier

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11 Scopus citations


There has been little attention given to the relationship between variations in normal craniofacial morphology and swallowing physiology. This preliminary investigation evaluated the relationship between the Frankfort-mandibular plane angle (FMA) and hyoid displacement during swallowing. Hyoid movement was evaluated during 12-ml and 24-ml swallows of liquid barium in 12 healthy subjects (age = 20-29 years, median = 23 years). Lateral projection videofluorography was utilized. Positions of the hyoid at maximum forward displacement, maximum upward displacement, starting position, and ending position were determined using image analysis software. The mean FMA was 28.92° ± 4.08° (mean ± SD, range = 20°-34°). A Pearson correlation (≤0.05) demonstrated that hyoid forward displacement was significantly inversely correlated with the FMA [R = -0.68, p = 0.015 (12 ml) and R = -0.72, p = 0.009 (24 ml)]; thus, the greater the FMA, the smaller the hyoid forward displacement. Upward displacement of the hyoid was not significantly correlated with FMA for 12-ml (R = -0.41, p = 0.55) or 24-ml swallows (R = 0.21, p = 0.512). In addition, there was no significant correlation between hyoid starting or ending positions. In conclusion, the results of this preliminary study suggest that normal variations in morphology, as measured by the FMA, may influence hyoid movement and therefore affect swallowing physiology.

Original languageEnglish (US)
Pages (from-to)71-76
Number of pages6
Issue number1
StatePublished - Mar 2009

Bibliographical note

Funding Information:
This work was completed at the Department of Physical Medicine and Rehabilitation, Good Samaritan Hospital, Johns Hopkins University, Baltimore, Maryland. The work was supported in part by award Nos. T32 DE07309 from the NIDCR/NIH and R01 DC002123 from the NIDCD/NIH. The authors would like to thank Chune Yang for providing technical assistance, and the late Dr. Karen Hiiemae for her assistance in collecting data and planning this project.


  • Deglutition
  • Deglutition disorders
  • Fluoroscopy
  • Hyoid bone
  • Mandible
  • Mandibular rest position
  • Stomatognathic system


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