Assessment of cough in head and neck cancer patients at risk for dysphagia—An overview

Mootassim-Billah, Sofiana; Nuffelen, Gwen Van; Schoentgen, Jean; Bodt, Marc De; Dragan, Tatiana; Digonnet, Antoine; Roper, Nicolas; Gestel, Dirk Van

doi:10.1002/cnr2.1395

Cited by 6 publications

(4 citation statements)

References 116 publications

(288 reference statements)

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“…Moreover, our study population presented oral symptoms such as coughing and sticky saliva (items extracted from the EORTC QLQ-H&N35 questionnaire). These symptoms, added to the sensory deterioration due to oncological treatment may induce an inefficient cough reflex and thus increase the risk of dysphagia [ 29 ]. Consistent with our results, Nguyen and colleagues [ 30 ] found that only 40% of patients with HNC with dysphagia have an effective cough response to aspirated material, and, as described by Beetz and colleagues, [ 31 ] 43% of patients with HNC reported moderate to severe sticky saliva at 6 months after treatment with primary chemoradiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Exploring predictors of dysphagia in survivors of head and neck cancer: A cross-sectional study

López-Fernández,

Fernández-Lao,

Ruíz-Martínez

et al. 2024

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Purpose To evaluate the prevalence of dysphagia in survivors of head and neck cancer (sHNC) and to identify the predictors contributing to the development of dysphagia. Methods We enrolled 62 sHNC in a cross-sectional study to check the prevalence of dysphagia in sHNC and to evaluate which factors were influencing the presence of this side effect. Besides dysphagia, sociodemographic and clinical characteristics, oral symptoms, maximal mouth opening (MMO), sleep quality and physical condition were evaluated, and a linear regression analysis was performed to verify which of these outcomes impact dysphagia. Results Among all the sHNC, 85.5% presented dysphagia. The linear regression analysis confirmed that 44.9% of the variance in dysphagia was determined by coughing, MMO and sleep quality, being MMO the most powerful predictor, followed by coughing and sleep quality. Conclusion Dysphagia affected the great majority of sHNC. Moreover, symptoms as coughing, reduced MMO and sleep disorders may act as predictors contributing to the development of dysphagia. Our results emphasize the importance of an early and proper identification of the symptoms as well as an adequate treatment strategy to address the cluster of symptoms that sHNC undergo.

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Section: Discussionmentioning

confidence: 99%

Exploring predictors of dysphagia in survivors of head and neck cancer: A cross-sectional study

López-Fernández,

Fernández-Lao,

Ruíz-Martínez

et al. 2024

Support Care Cancer

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“…The comparison of the voluntary cough signals recorded by the two transducers showed that the skin-contact microphone underreports high-frequency components [49]. This observation may be explained by the attenuation of the acoustic signal propagating through the tissue of the neck before the signal is recorded by the skin-contact microphone, but also by the lack of the boosting of the high-frequency components (high-pass filtering) of the cough signal owing to the acoustic radiation at the lips.…”

Section: Discussionmentioning

confidence: 99%

“…As reported in our previous overview [14], established cough assessment includes aerodynamic, acoustic measures, and perceptual ratings. While examining reflexive coughs induced with a tussigen, cough airflow-related measures are currently regarded as reliable markers of dysphagia and Extended author information available on the last page of the article aspiration in patients with neurological disorders [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Acoustic Analysis of Voluntary Coughs, Throat Clearings, and Induced Reflexive Coughs in a Healthy Population

Mootassim-Billah,

Schoentgen,

De Bodt

et al. 2023

Dysphagia

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Cough efficacy is considered a reliable predictor of the aspiration risk in head and neck cancer patients with radiation-associated dysphagia. Currently, coughing is assessed perceptually or aerodynamically. The goal of our research is to develop methods of acoustic cough analysis. In this study, we examined in a healthy population the acoustical differences between three protective maneuvers: voluntary cough, voluntary throat clearing, and induced reflexive cough. Forty healthy participants were included in this study. Voluntary cough, voluntary throat clearing, and reflexive cough samples were recorded and analyzed acoustically. Temporal acoustic features were the following: the slope and curvature of the amplitude contour, as well as the average, slope, and curvature of the sample entropy and kurtosis contours of the recorded signal. Spectral features were the relative energy in the frequency bands (0–400 Hz, 400–800 Hz, 800–1600 Hz, 1600 Hz-3200 Hz, > 3200 Hz) as well as the weighted spectral energy. Results showed that, compared to a voluntary cough, a throat clearing starts with a weaker onset pulse and involves oscillations from the onset to the offset (concave curvature of the amplitude contour, p < 0.05), lower average (p < 0.05), and slope (p < 0.05) as well as lower convex curvature (p < 0.05) of the kurtosis contour. An induced reflexive cough starts with a higher and briefer onset burst and includes higher frication noise (larger convexity of the curvature of the amplitude and kurtosis contours (p < 0.05)) compared to a voluntary cough. The conclusion is that voluntary coughs are acoustically significantly different from voluntary throat clearings and induced reflexive coughs.

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“…However, in practice, clinical examination of swallow is more frequently carried out by speech and language therapists. Clinical evaluation of oropharyngeal dysphagia often includes oral motor exam (Logemann et al., 1999), observation of coughing behaviour (Mootassim‐Billah et al., 2021) and sometimes palpation of laryngeal movement to detect aspiration (Felix et al., 2019). These procedures are relatively easy and simple to administer and are often used as the first line of assessment for oropharyngeal dysphagia.…”

Section: Introductionmentioning

confidence: 99%

Acoustic characteristics associated with liquid swallowing sounds of different bolus consistencies in young healthy adults

2022

Intl J Lang & Comm Disor

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Background: Cervical auscultation has been used clinically as an augmentative procedure for swallow examination. Despite its frequent use for screening and preliminary assessment of swallowing, the usefulness of cervical auscultation is controversial due to a lack of sufficient research, particularly in quantifying swallowing sounds. Aims:To document the acoustic characteristics of normal swallowing sound associated with swallowing bolus of different consistencies among younger healthy adults. Methods & Procedures: A total of 30 healthy young adult participants swallowed 5 ml thickened liquids of four different consistencies (slightly thick, mildly thick, moderately thick and extremely thick) prepared using a starchbased commercial thickener, and the corresponding swallowing sounds were recorded using a wireless accelerometric stethoscope. An array of acoustic measures including duration of swallowing sound (DSS), duration to peak intensity (DPI), frequency at peak intensity (FPI), peak intensity (PI), average intensity (AI), and difference between peak and average intensity (DPAI) values associated with the swallowing signals were obtained. Outcomes & Results:In general, increased durational measures of the swallowing sounds were associated with an increase in bolus consistency. Intensity measures including PI, AI and DPAI were found to be stable across different consistencies. The change in FPI did not appear to be particularly meaningful due to its high variability. In addition, no significant differences were observed between men and women.Conclusions & Implications: Swallow sounds associated with different bolus consistencies could be quantified and used to differentiate consistencies. The present findings could serve as a reference for future swallowing research of normal and dysphagic population.

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Assessment of cough in head and neck cancer patients at risk for dysphagia—An overview

Cited by 6 publications

References 116 publications

Exploring predictors of dysphagia in survivors of head and neck cancer: A cross-sectional study

Exploring predictors of dysphagia in survivors of head and neck cancer: A cross-sectional study

Acoustic Analysis of Voluntary Coughs, Throat Clearings, and Induced Reflexive Coughs in a Healthy Population

Acoustic characteristics associated with liquid swallowing sounds of different bolus consistencies in young healthy adults

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