Article

OBJECTIVE: To perform acoustic analysis of swallowing sounds, using a microphone
and a notebook computer system, in healthy subjects and patients with dysphagia
affected by neurological diseases, testing the positive/negative predictive value
of a pathological pattern of swallowing sounds for penetration/aspiration.
DESIGN: Diagnostic test study, prospective, not blinded, with the
penetration/aspiration evaluated by fibreoptic endoscopy of swallowing as
criterion standard. SUBJECTS: Data from a previously recorded database of normal
swallowing sounds for 60 healthy subjects according to gender, age, and bolus
consistency was compared with those of 15 patients with dysphagia from a
university hospital referral centre who were affected by various neurological
diseases. METHODS: Mean duration of the swallowing sounds and post-swallowing
apnoea were recorded. Penetration/aspiration was verified by fibreoptic endoscopy
of swallowing in all patients with dysphagia. RESULTS: The mean duration of
swallowing sounds for a liquid bolus of 10 ml water was significantly different
between patients with dysphagia and healthy patients. We also described patterns
of swallowing sounds and tested the negative/positive predictive values of
post-swallowing apnoea for penetration/aspiration verified by fibreoptic
endoscopy of swallowing (sensitivity 0.67 (95% confidence interval 0.24-0.94);
specificity 1.00 (95% confidence interval 0.56-1.00)). CONCLUSION: The proposed
technique for recording and measuring swallowing sounds could be incorporated
into the bedside evaluation, but it should not replace the use of more diagnostic
and valuable measures.

Langue : ANGLAIS