Cervical Vertebral Height Approximates Hyoid Displacement in Videofluoroscopic Images of Healthy Adults

Mahoney, Amanda S.; Khalifa, Yassin; Lucatorto, Erin; Sejdić, Ervin; Coyle, James L.

doi:10.1007/s00455-022-10414-8

Cited by 5 publications

(1 citation statement)

References 27 publications

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“…The measured A-P UES opening maximal distension value was divided by the length of the C2C4 segment to standardize and compensate for the height of each patient. The C2C4 segment length represents a part of the vertebral column which corresponds with the patient’s height, so we used this as a standardization procedure for the A-P UES opening maximal distension value as followed in multiple studies [29] , [30] , [31] .…”

Section: Methodsmentioning

confidence: 99%

Non-Invasive Sensor-Based Estimation of Anterior-Posterior Upper Esophageal Sphincter Opening Maximal Distension

Khalifa

Mahoney

Lucatorto

et al. 2023

IEEE J. Transl. Eng. Health Med.

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Objective: Dysphagia management relies on the evaluation of the temporospatial kinematic events of swallowing performed in videofluoroscopy (VF) by trained clinicians. The upper esophageal sphincter (UES) opening distension represents one of the important kinematic events that contribute to healthy swallowing. Insufficient distension of UES opening can lead to an accumulation of pharyngeal residue and subsequent aspiration which in turn can lead to adverse outcomes such as pneumonia. VF is usually used for the temporal and spatial evaluation of the UES opening; however, VF is not available in all clinical settings and may be inappropriate or undesirable for some patients. High resolution cervical auscultation (HRCA) is a noninvasive technology that uses neck-attached sensors and machine learning to characterize swallowing physiology by analyzing the swallow-induced vibrations/sounds in the anterior neck region. We investigated the ability of HRCA to noninvasively estimate the maximal distension of anterior-posterior (A-P) UES opening as accurately as the measurements performed by human judges from VF images. Methods and procedures: Trained judges performed the kinematic measurement of UES opening duration and A-P UES opening maximal distension on 434 swallows collected from 133 patients. We used a hybrid convolutional recurrent neural network supported by attention mechanisms which takes HRCA raw signals as input and estimates the value of the A-P UES opening maximal distension as output. Results: The proposed network estimated the A-P UES opening maximal distension with an absolute percentage error of 30% or less for more than 64.14% of the swallows in the dataset. Conclusion: This study provides substantial evidence for the feasibility of using HRCA to estimate one of the key spatial kinematic measurements used for dysphagia characterization and management. Clinical and Translational Impact Statement: The findings in this study have a direct impact on dysphagia diagnosis and management through providing a non-invasive and cheap way to estimate one of the most important swallowing kinematics, the UES opening distension, that contributes to safe swallowing. This study, along with other studies that utilize HRCA for swallowing kinematic analysis, paves the way for developing a widely available and easy-to-use tool for dysphagia diagnosis and management.

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Section: Methodsmentioning

confidence: 99%

Non-Invasive Sensor-Based Estimation of Anterior-Posterior Upper Esophageal Sphincter Opening Maximal Distension

Khalifa

Mahoney

Lucatorto

et al. 2023

IEEE J. Transl. Eng. Health Med.

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Validity and reliability of the Group for Learning Useful and Performant Swallowing (GLUPS) tool

Lechien,

Blouin,

Baudouin

et al. 2023

Eur Arch Otorhinolaryngol

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Radiographic Magnification on Videofluoroscopy: An Important Variable to Consider for Scaled Analyses of Swallowing

Molfenter,

Jones-Rastelli,

Balou

2024

J Speech Lang Hear Res

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Purpose: Traditionally, kinematic measures on videofluoroscopy require the use of an external scalar (such as a penny) to transform pixels to absolute distances. Videofluoroscopy is subject to image magnification based on the distance of the feature of interest to the X-ray source. However, the impact of the position/location of the external scalar on swallowing measures is unknown. Our goal was to systematically investigate the accuracy of various common external scalar locations in lateral and anterior–posterior (A-P) view. Method: U.S. pennies were taped to a styrofoam head in three positions (on the left and right lateral neck and in midline submentally). Locations were measured to ensure equal left and right, as well as midline, placement. A metal screwdriver (6 mm in diameter) was inserted into the premanufactured hole that is centrally located at the bottom of the styrofoam head. The head was centered on a medical tray and placed in the middle of a Siemens Alpha C-arm Fluoroscope field. ImageJ was used to measure penny length in pixels (three locations) in both lateral and A-P views. Penny length was known (19.05 mm), and, therefore, used to derive screwdriver size (for each location) for comparison to the actual screwdriver size. Results: All scalars overestimated the screwdriver size ranging from 6.55 to 7.87 mm, representing a 9%–31% inflation. Scalars closer to the X-ray source had the largest magnification. Conclusions: Our results confirm that image magnification of external scalars is a significant source of variability that is currently unaccounted for in the swallowing literature. Recommendations for future research design/measurement methods are provided.

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Cervical Vertebral Height Approximates Hyoid Displacement in Videofluoroscopic Images of Healthy Adults

Cited by 5 publications

References 27 publications

Non-Invasive Sensor-Based Estimation of Anterior-Posterior Upper Esophageal Sphincter Opening Maximal Distension

Non-Invasive Sensor-Based Estimation of Anterior-Posterior Upper Esophageal Sphincter Opening Maximal Distension

Validity and reliability of the Group for Learning Useful and Performant Swallowing (GLUPS) tool

Radiographic Magnification on Videofluoroscopy: An Important Variable to Consider for Scaled Analyses of Swallowing

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