Videographic-Free Tracking of Hyoid Bone Displacement During Swallowing Using Accelerometer Signals and Transformers

Abstract

Objective: Accurate tracking of anatomical landmarks during swallowing is critical for early diagnosis and treatment of dysphagia. Hyoid bone displacement plays a pivotal role in upper esophageal sphincter opening and airway protection, traditionally assessed via a videofluoroscopic swallow study (VFSS). However, VFSSs are subjective, expose patients to radiation, and are not universally accessible. High-resolution cervical auscultation (HRCA) offers a noninvasive alternative, utilizing acoustic and vibratory signals. Prior studies have validated HRCA’s efficacy in analyzing swallowing kinematics and correlating with hyoid bone displacement, typically employing transform domain characteristics and recurrent neural networks to achieve 50% overlap in predicted displacementsMethods: We introduce a transformer-based architecture for tracking hyoid bone displacement directly from raw HRCA signals, leveraging advanced temporal and spatial feature extraction methods using attention mechanism. The proposed pipeline preprocesses HRCA signals, segments individual swallows, and tracks the hyoid bone.Results: Our approach significantly improves upon existing methods, achieving over 70% relative overlap in predicted hyoid bone displacements across validation folds, surpassing state-of-the-art baseline models by a margin of at least 20%. Comprehensive statistical analysis confirms the robustness and accuracy of our predictions, demonstrating strong generalization capabilities on an independent dataset.Conclusion: This novel approach underscores the potential of transformer models in promoting noninvasive dysphagia assessment, offering a precise tracking of hyoid bone without VFSS images, and providing clinicians with insights about its movement trends, potentially aiding in clinical decision-making and bringing us one step closer to automated noninvasive swallowing assessment protocols. Clinical Impact– This study highlights the potential of automated hyoid bone tracking using HRCA signals to enhance dysphagia assessment by providing objective, noninvasive measurements that potentially support earlier detection and monitoring of swallowing impairments in both clinical and home healthcare settings, ultimately improving patient management and treatment outcomes.