Article

In this study we explored the validity of clinician judgments of voice
abnormalities as indicators of penetration-aspiration or other swallowing
abnormalities. Voice samples were collected using a high-quality microphone from
40 adults during videofluoroscopy (VFSS), at baseline and following each of four
thin liquid swallows. Blinded speech-language pathologists (SLPs) rated the audio
recordings for voice quality using the GRBAS scale and the VFSS recordings for
abnormal swallow onset, penetration-aspiration, airway closure, and pharyngeal
residues. Acoustic measures of % jitter, % shimmer, and signal-to-noise ratio
were calculated using two /a/ vowel segments spliced from each voice recording.
Preswallow to postswallow measures of voice-quality change were derived and the
data were compared to determine the correspondence between perceived voice
abnormalities, acoustic voice parameters, and radiographically confirmed
swallowing abnormalities. The sensitivity of perceived postswallow changes in
voice quality to dysphagia and penetration-aspiration was poor, ranging from 8 to
29%. Specificity was stronger for both penetration-aspiration (75-94%) and
dysphagia (59-86%). Acoustic measures of voice quality had moderate sensitivity
and specificity for both dysphagia and penetration-aspiration. Overall,
perceptual judgments of postswallow wet voice showed the strongest potential for
detecting penetration-aspiration (relative risk = 3.24). We conclude that a clear
postswallow voice quality provides reasonable evidence that
penetration-aspiration and dysphagia are absent. However, observations of
abnormal postswallow voice quality can be misleading and are not a valid
indication that penetration-aspiration or dysphagia exists.

Langue : ANGLAIS