Cervical auscultation synchronized with images from endoscopy swallow evaluations

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Biomedical Engineering

Background:

• Cervical auscultation, using stethoscopes to analyze swallow sounds, is a clinical practice for assessing swallowing function.
• A significant criticism is the lack of evidence correlating these sounds with specific physiological events or their clinical significance.

Purpose of the Study:

• To investigate if distinct swallow sounds can be identified in healthy volunteers.
• To determine the temporal relationship between swallow sounds and physiological events during swallowing.
• To assess the ability to match specific swallow sounds to observed physiological events.

Main Methods:

• Swallow sounds were recorded using a stethoscope in 19 healthy volunteers.
• Simultaneous fiberoptic laryngoscopy and respiration monitoring were employed.
• Recorded sounds were analyzed for distinct components and their timing relative to physiological events.

Main Results:

• Six sound components were identified, but none were present in all swallows.
• Significant overlap and wide variation were observed in the timing of sounds and physiological events.
• No single sound component consistently correlated with a specific physiological event.

Conclusions:

• Current evidence does not support the routine clinical adoption of cervical auscultation for swallowing assessment.
• The technique requires further validation, potentially using imaging methods like videofluoroscopy, before integration into clinical guidelines.
• While absence of sound is not definitive, abnormal patterns may suggest impairment, warranting further research.