Exploration of Pharyngeal Swallowing by Audiosignal Recording

Abstract

The aims of this study were to analyze the following by audiorecording of swallows: (1) the influence on the volume and consistency of ingested substances on the audiosignal recorded during separate swallows; and (2) the characteristics of successive swallows during ingestion of 100 ml of the same substances to define deglutitive behaviors. Volunteers followed two protocols. Protocol (P) 1 comprised ingestion of 100 ml of water or yoghurt in successive swallows and Protocol 2 comprised separate swallows of different volumes of the same substances. Audiosignal recordings were made with a dynamic microphone. The following parameters were measured in P1: total time of ingestion (TT), number of swallows necessary for ingestion (N), and spontaneous swallowing intervals (SI). In P2 the duration (d) of each signal was measured according to consistency and volume. Mean (m) values were then calculated (TTm, Nm, SIm, and dm). During P1, TTm for yoghurt was significantly longer than for water (23.1 vs. 6.5 sec (men) and 21.8 vs. 7.8 sec (women). Nm was also greater for yoghurt (10.1 vs. 4.3 (men) and 10.0 vs. 4.8 (women). Three types of swallowing behavior were defined according to SI: swallowing at regular intervals (Reg) with increasing intervals during ingestion (Prog) and swallowing at variable intervals (Irreg). These patterns did not differ significantly according to sex. In P2 the increase in volume swallowed increased the duration (dm) of the signal for water (600 msec for 5 ml and 960 msec for 15 ml). The dm for yoghurt was significantly less than for water (580 msec for 5 ml and 920 msec for 15 ml). Our technique of recording sounds of pharyngeal swallowing is simple, reproducible, and not expensive. It permitted the analysis of each swallow according to volume and consistency and the determination of three swallowing patterns (Reg, Prog, and Irreg), taking into account the spontaneous swallowing interval. Ingestion by successive swallows could be used to characterize certain pharyngoesophageal motor dysfunctioning in relation to this reference population and to integrate this into a deglutition rehabilitation program.

Outcomes of Swallowing Rehabilitation in Chronic Brainstem Dysphagia: A Retrospective Evaluation

“…The stethoscope bell was placed over the lateral lamina of the thyroid cartilage to monitor the acoustic signal associated with swallowing. Although ''cervical auscultation'' has been the focus of significant recent research as a clinical diagnostic tool [27][28][29][30][31], its application as a biofeedback modality is significantly less complex and has not previously been reported in the literature. Execution of a Mendelsohn maneuver requires sustaining laryngeal excursion during the swallow or prolonging the swallow.…”

Coordination of Sucking, Swallowing, and Breathing and Oxygen Saturation During Early Infant Breast-feeding and Bottle-feeding

“…A catheter identical to the one previously attached to the mother's breast was embedded within the bottle nipple so that it entered the infant's mouth during feeding. To record swallowing, a miniature wireless microphone (SC4-CT; Shure, Inc., Niles, IL) was secured with tape to the skin beneath the cricoid and oriented toward the pharynx (14). To record respiratory movements, inductance bands (Inductotrace respiratory monitors; Ambulatory Monitoring, Inc., Ardsley, NY) were secured around the infant's chest and abdomen, and an oxygen saturation sensor was also secured on one foot; the signal from the latter was analyzed by a pulse oximeter (Radical; Masimo Corporation, Irvine, CA).…”

Investigating the stationarity of paediatric aspiration signals

“…The identification of aspiration is critical to rehabilitation planning for the individual with dysphagia. Numerous aspiration detection technologies along with accompanying clinical screening procedures have been proposed in the literature (see [1] for a review), including, for example, fiberoptic endoscopy [12], pulse oximetry [13], electroglottography (EGG) [14], cervical auscultation with pharyngeal microphone [15], and the present-day gold standard, the modified barium swallow using videofluoroscopy [10]. There is, however, a practical need for a noninvasive, economical, and portable method for detecting aspiration [16] at the bedside and outside of the institutional setting.…”