Abstract
The assessment of swallowing function is important for the prevention of aspiration pneumonia. We developed a new swallowing monitoring system that uses respiratory flow, swallowing sound, and laryngeal motion. We applied this device to 11 healthy volunteers and 10 patients with dysphagia. Videofluoroscopy (VF) was conducted simultaneously with swallowing monitoring using our device. We measured laryngeal rising time (LRT), the time required for the larynx to elevate to the highest position, and laryngeal activation duration (LAD), the duration between the onset of rapid laryngeal elevation and the time when the larynx returned to the lowest position. In addition, we evaluated the coordination between swallowing and breathing. We found that LAD was correlated with a VF-derived parameter, pharyngeal response duration (PRD) in healthy subjects (LAD: 959 ± 259 ms vs. PRD: 1062 ± 149 ms, r = 0.60); however, this correlation was not found in the dysphagia patients. LRT was significantly prolonged in patients (healthy subjects: 320 ± 175 ms vs. patients: 465 ± 295 ms, P < 0.001, t test). Furthermore, frequency of swallowing immediately after inspiration was significantly increased in patients. Therefore, the new device may facilitate the assessment of some aspects of swallowing dysfunction.
Highlights
Dysphagia, or swallowing difficulty, is the medical term for a condition in which the swallowing process is disrupted and eating ability is impaired
This paper mainly focuses on the method by which the new swallowing monitoring system detects swallowing events and assesses swallowing function from collected signal components, i.e., a respiratory flow, swallowing sound, and laryngeal motion
Additional swallowing candidate periods contain false-positive detections due to environmental noises, e.g., speech, motion artifacts, and electrical interference. The sound within these respiratory cessation periods was played back, and two speech therapists independently judged whether the sound and the laryngeal motion (Fig. 5b) were compatible with a swallow
Summary
Swallowing difficulty, is the medical term for a condition in which the swallowing process is disrupted and eating ability is impaired. Patients with dysphagia can be at higher risk of pulmonary aspiration and subsequent aspiration pneumonia. According to WHO report in 2012, pneumonia was at third rank among causes of death in the world Who.int/mediacentre/factsheets/fs310/en/), and the majority of pneumonia cases in the elderly population are associated with aspiration. Swallowing abnormality may contribute to exacerbations of pulmonary diseases [4, 10, 13, 24, 33, 43, 44]. Recurrence of aspiration pneumonia frequently occurs if the underlying swallowing problems have not been properly treated. The assessment of swallowing function and early intervention are critical
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