Objective
To identify early clinical predictors associated with dysphagia and delayed swallowing recovery in patients with traumatic brain injury (TBI).
Methods
In this retrospective study, we enrolled adult TBI patients admitted to the rehabilitation unit of a tertiary medical center between June 2019 and June 2023. Data on baseline characteristics, neurological status, imaging findings, and rehabilitation-related variables were collected. Swallowing function was assessed using two indicators: (1) nasogastric (NG) tube retention and (2) the Functional Oral Intake Scale (FOIS) scores at 1, 4, and 12 weeks post-injury. Regression analyses were conducted to identify predictors associated with dysphagia and swallowing recovery.
Results
A total of 160 patients were included. At 1 week post-injury, longer intensive care unit (ICU) stay, poor initial sitting balance and use of sedative medication in ICU were associated with NG tube retention. At 4 weeks, lower initial Rancho Los Amigos Scale (RLAS) scores, immobility-related complications, longer hospitalization, and temporal lobe hematomas were associated with persistent NG tube dependence. By 12 weeks, older age, delayed ability to follow commands, and poor initial sitting balance remained associated with NG tube retention. FOIS outcomes were also associated with older age, delayed time to follow commands, impaired initial sitting balance, prolonged ICU stay, temporal lobe hematomas, lower initial RLAS scores, immobility-related complications, prolonged endotracheal tube placement and extended hospital stays.
Conclusion
Impaired cognitive status, poor physical function, immobility-related complications, and temporal lobe hematomas were key factors associated with dysphagia and delayed oral intake in individuals with TBI.

Objective
To investigate the temporal and kinematic parameters of hyoid bone excursion (HBE) in head and neck cancer (HNC) patients with and without aspiration.
Methods
Videofluoroscopic swallowing study images from 28 HNC patients were divided into aspiration and non-aspiration groups. The kinematic parameters of HBE, including displacement, instantaneous velocity, and instantaneous acceleration, as well as the timing of reaching maximal values in these parameters, were analyzed.
Results
The timings of reaching maximal horizontal (2.37±1.10 seconds vs. 1.09±1.58 seconds, p=0.010; 0.68±0.28 vs. 0.37±0.26, p=0.010 for percentage of time), vertical (1.83±2.06 seconds vs. 0.86±1.42 seconds, p=0.020) and hypotenuse instantaneous velocities (2.36±1.96 seconds vs. 0.79±1.20 seconds, p=0.006; 0.60±0.33 vs. 0.33±0.24, p=0.028 for percentage of time), as well as the timings of reaching maximal horizontal (2.22±1.50 seconds vs. 0.90±1.26 seconds, p=0.009; 0.60±0.32 vs. 0.37±0.29, p=0.041 for percentage of time), vertical (2.09±1.94 seconds vs. 0.83±1.19 seconds, p=0.003), and hypotenuse instantaneous accelerations (2.49±1.93 seconds vs. 0.81±1.24 seconds, p=0.004; 0.65±0.34 vs. 0.34±0.28, p=0.026 for percentage of time) were significantly prolonged in the aspiration group. After signal smoothing, the aspiration group exhibited delayed timing in reaching maximal horizontal instantaneous velocity (2.07±1.09 seconds vs. 0.74±1.10 seconds, p=0.004; 0.58±0.29 vs. 0.32±0.24, p=0.017 for percentage of time), as well as maximal horizontal (2.18±1.16 seconds vs. 1.12±1.46 seconds, p=0.008) and hypotenuse accelerations (2.21±2.50 seconds vs. 0.81±1.21 seconds, p=0.011). There were no significant between-group differences in other kinematic parameters, except for horizontal displacement (7.66±6.26 mm vs. 12.14±5.82 mm, p=0.042).
Conclusion
The timings of reaching maximal instantaneous velocities and accelerations of HBE, rather than the maximum values of these kinematic parameters, may be critical parameters related to aspiration in HNC patients.