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Diagnosing of Dysphagia Using Acoustic Characteristics of Swallowing and Expiratory Sounds

  • TAKADA Yoshinao
    Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry
  • TAKAHASHI Koji
    Department of Oral Rehabilitation, Showa University School of Dentistry
  • NAKAYAMA Hiroshi
    Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry
  • UYAMA Risa
    Department of Oral Rehabilitation, Showa University School of Dentistry
  • HIRANO Kaoru
    Department of Oral Rehabilitation, Showa University School of Dentistry
  • FUKASAWA Miki
    Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry
  • NAGUMO Masao
    Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry

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Other Title
  • 嚥下音・呼気音を利用した嚥下障害の客観的評価

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Abstract

This study was designed to objectively differentiate dysphagic swallow from safe swallow using acoustic characteristics of swallowing and expiratory sounds. Twenty-six postsurgical head and neck cancer patients with swallowing disorder were served as subjects. During VF examination, swallowing sounds and voluntary expiratory sounds after the swallows were detected using our method and fed to a digital video recorder with VF images of these swallows and expiratory events. Acoustic signals of swallowing and expiratory sounds were analyzed by our computed acoustic analyzing system to obtain the duration of swallowing sounds and the averaged revised levels of the six target bands from 63 Hz to 200 Hz of expiratory sounds using the 1/3 octave band analyses. Both 92 swallowing sounds and 46 voluntary expiratory sounds after the swallows were analyzed and compared with the VF findings. Compared with the abnormal group (aspiration or penetration was found on VF image), the safety group without these findings was longer in duration of swallowing sound signals and greater in revised levels of the expiratory sound signals. Zero point eightyeight seconds was set as the critical duration of swallowing sound signals in order to differentiate dysphagic swallows from safe swallows. Seventeen point two dB was also set as the critical revised levels of the expiratory sound signals for differentiating dysphagic from safe swallows. If the both analyzed data of swallowing and expiratory sound signals were over these critical values, the swallows were assessed to be dysphagic. Comparison of these assessments with the differentiations from the VF findings showed significant agreement. Sensitivity was 82.6% (38/46), specificity was 100% (46/46), positive predictive value was 100% (38/38), negative predictive value was 85.2% (46/54) and percent agreement was 91.3% (84/92). These results suggest that duration of the swallowing sounds and revised levels of the expiratory sounds can be used for detecting dysphagic swallow.

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