Acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia

Yamashita, Madoka; Yokoyama, Keitaro; Takei, Yoshiko; Furuya, Nanae; Nakamichi, Yuka; Ihara, Yoshiaki; Takahashi, Koji; Groher, Michael E.

doi:10.1111/joor.12184

Cited by 13 publications

(12 citation statements)

References 13 publications

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“…The sensitivity and specificity of US for detecting residue were not always higher than the results of previous methods [9,10] which aimed to detect dysphagia including pharyngeal post-swallow A 76-year-old man with a history of Parkinson's disease and stroke underwent FEES to evaluate changes in his swallowing ability. He complained of increased sputum after he had a fever 2 weeks earlier.…”

Section: Discussionmentioning

confidence: 99%

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Detecting pharyngeal post-swallow residue by ultrasound examination: a case series.

et al. 2016

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Aims: Prevention of aspiration pneumonia is a great concern in the era of global aging. The assessment of pharyngeal post-swallow residue is important because remaining food and liquid in the pharyngeal area has a possibility of flowing into the lower airway which can cause aspiration pneumonia. Ultrasound examination has been recently used to assess swallowing disorders because of its noninvasiveness. The aim of this study was to investigate the performance for detecting pharyngeal post-swallow residue using an ultrasound examination by comparing with those using a fiberoptic endoscopic evaluation of a swallowing study as a reference. Material and methods: A linear array transducer attached to the thyroid cartilage to visualize the vocal folds in the sagittal plane. The pharyngeal post-swallow residue in the ultrasound movie was interpreted as a misty hyperechoic area above the vocal folds that remained after swallowing. Nineteen ultrasound images simultaneously obtained with fiberoptic endoscopic evaluation of swallowing study images from nine participants (eight men) with a median age of 70 years at a dysphagia outpatient clinic were analyzed by the montage of swallowing examinations. Results: Misty hyperechoic areas above the vocal folds that remained after swallowing were detected in 10 ultrasound images. Eight ultrasound images out of ten correctly detected pharyngeal post-swallow residue. The sensitivity for detecting pharyngeal post-swallow residue of 19 images from nine participants by ultrasound examination was 62%, and the specificity was 67%. Conclusions: The proposed detection method of pharyngeal post-swallow residue by ultrasound examination enabled the real-time assessment for swallowing of people with dysphagia. Ultrasound assessment-based daily swallowing care which detects pharyngeal residue will be useful for preventing aspiration pneumonia.

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Section: Discussionmentioning

confidence: 99%

“…A few researchers have tried to detect pharyngeal post-swallow residue using acoustic measurements as less invasive way [9,10]. They tried to assess pharyngeal post-swallow residue that was detected through VFSS or FEES from the voice or breath sounds after swallowing.…”

Section: Introductionmentioning

confidence: 99%

Detecting pharyngeal post-swallow residue by ultrasound examination: a case series.

et al. 2016

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“…The sequentially detected acoustic signals including pre‐swallow ES, SS, and post‐swallow ES were amplified, digitally converted at a sampling rate of 48 kHz and recorded with VFSS images on DVCAM tape using a digital high‐definition videotape recorder. A diagram of the recording system is presented in Figure (Yamashita et al, ).…”

Section: Methodsmentioning

confidence: 99%

Accuracy of cervical auscultation in detecting the presence of material in the airway

Nozue

Ihara

Takahashi

et al. 2017

Clinical & Exp Dental Res

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Several studies have investigated the accuracy of cervical auscultation (CA). However, both the sensitivities and the specificities of CA in detecting dysphagic conditions varied widely among these studies. These wide variations of the accuracy of CA might be caused by differences of the targeted sounds, such as the expiratory sound (ES) and/or swallowing sound (SS). Forty‐six dysphagic patients were served as subjects. Patients who had unoccluded tracheostoma and patients who could not follow the instructions were excluded. During the videofluorographic swallowing study (VFSS), the subjects swallowed 3 ml of yogurt containing barium sulfate. The VFSS images were recorded with acoustic signals including both the swallowing and respiratory sounds detected by our method. Classification of the VFSS images was decided by consensus of the three dentists using a penetration‐aspiration scale (PAS). Recorded VFSS images were classified into the following 2 groups based on PAS: “no or minimum risk group”: PAS1–2; and “possible risk group”: PAS3–8. As a result of the classification of VFSS findings, 30 samples were evaluated as no or minimum risk group and 16 as possible risk group. Twelve observers including 10 dentists other than 3 dentists who evaluated VFSS images and 2 speech pathologists auditorily diagnosed “negative” and “positive.” Sensitivity, specificity, and intra‐rater reliability was calculated for the 3 types of acoustic samples. The sensitivity of the intra‐rater reliability was 60.3% for ES, 76.6% for SS, and 89.9% for ES + SS. The sensitivity of intra‐rater reliability of ES + SS samples was significantly higher than that of ES (p < .01) and SS (p < .05). The sensitivity of intra‐rater reliability of SS was significantly higher than that of ES (p < .01). The specificity of the intra‐rater reliability was 53.7% for ES, 50.3% for SS, and 44.5% for ES + SS. ES + SS might be most useful for detecting the presence of material in the airway.

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“…Detecting abnormal sounds by cervical auscultation is a less invasive method than FEES, but a provider must be highly trained to be able to interpret the sounds or to perform complicated acoustic analyses. 11,12 Thus, a less invasive imaging tool to visualize the pyriform sinus and epiglottic vallecula in real time would assist care professionals, including nurses, in removing the residue, and it would help prevent aspiration pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Establishing a Methodology for Ultrasound Evaluation of Pharyngeal Residue in the Pyriform Sinus and Epiglottic Vallecula

Miura

Yabunaka²,

Karube

et al. 2019

Respir Care

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BACKGROUND: Assessing the presence of pharyngeal residue in the pyriform sinus and epiglottic vallecula is important because insufficient pharyngeal clearance is a risk factor for aspiration pneumonia. Improvements in the performance of ultrasound to visualize the pyriform sinus and epiglottic vallecula are needed. The aim of this study was to establish a method to visualize the pyriform sinus and epiglottic vallecula with ultrasound to detect pharyngeal residue. METHODS: We used real-time virtual sonography (ie, a fusion of magnetic resonance imaging and ultrasound imaging) as the scanning method to visualize the pyriform sinus and epiglottic vallecula without residue in 4 healthy individuals. Using established ultrasound methodology and fiberoptic endoscopic evaluation of swallowing, 35 subjects with dysphagia were studied to investigate the performance of ultrasound to detect pharyngeal residue. RESULTS: The fusion ultrasound images showed that transverse scans at the level of the laryngeal prominence and above the hyoid bone using a linear array transducer can be used to visualize the pyriform sinus and the epiglottic vallecula, respectively. We obtained 238 ultrasound images of the pyriform sinus from 35 subjects and 82 images of epiglottic vallecula from 26 of 35 subjects. The ultrasound images with fiberoptic endoscopic evaluation of swallowing showed that areas of high echogenicity in the pyriform sinus and epiglottic vallecula are related to the presence of pharyngeal residue. The presence of high-echogenicity areas resulted in a sensitivity of 92.0% and specificity of 71.9% for detecting pharyngeal residue in the pyriform sinus and a sensitivity of 86.7% and specificity of 63.6% for detecting pharyngeal residue in the epiglottic vallecula. CONCLUSIONS: Transverse ultrasound scans at the level of the laryngeal prominence and above the hyoid bone enable the visualization of the pyriform sinus, epiglottic vallecula, and pharyngeal residue.

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Acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia

Cited by 13 publications

References 13 publications

Detecting pharyngeal post-swallow residue by ultrasound examination: a case series.

Detecting pharyngeal post-swallow residue by ultrasound examination: a case series.

Accuracy of cervical auscultation in detecting the presence of material in the airway

Establishing a Methodology for Ultrasound Evaluation of Pharyngeal Residue in the Pyriform Sinus and Epiglottic Vallecula

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