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The Prediction of Risk of Penetration–Aspiration Via Hyoid Bone Displacement Features

Published on Mar 27, 2019in Dysphagia 3.03
· DOI :10.1007/s00455-019-10000-5
Zhenwei Zhang (University of Pittsburgh), Subashan Perera44
Estimated H-index: 44
(University of Pittsburgh)
+ 4 AuthorsErvin Sejdić24
Estimated H-index: 24
(University of Pittsburgh)
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Abstract
Videofluoroscopic swallow studies are widely used in clinical and research settings to assess swallow function and to determine physiological impairments, diet recommendations, and treatment goals for people with dysphagia. Videofluoroscopy can be used to analyze biomechanical events of swallowing, including hyoid bone displacement, to differentiate between normal and disordered swallow functions. Previous research has found significant associations between hyoid bone displacement and penetration/aspiration during swallowing, but the predictive value of hyoid bone displacement during swallowing has not been explored. The primary objective of this study was to build a model based on aspects of hyoid bone displacement during swallowing to predict the extent of airway penetration or aspiration during swallowing. Aspects of hyoid bone displacement from 1433 swallows from patients referred for videofluoroscopy were analyzed to determine which aspects predicted risk of penetration and aspiration according to the Penetration–Aspiration Scale. A generalized estimating equation incorporating components of hyoid bone displacement and variables shown to impact penetration and aspiration (such as age, bolus volume, and viscosity) was used to evaluate penetration and aspiration risk. Results indicated that anterior-horizontal hyoid bone displacement was the only aspect of hyoid bone displacement predictive of penetration and aspiration risk. Further research should focus on improving the model performance by identifying additional physiological swallowing events that predict penetration and aspiration risk. The model built for this study, and future modified models, will be beneficial for clinicians to use in the assessment and treatment of people with dysphagia, and for potentially tracking improvement in hyolaryngeal excursion resulting from dysphagia treatment, thus mitigating adverse outcomes that can occur secondary to dysphagia.
  • References (24)
  • Citations (0)
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References24
Newest
Faezeh Movahedi2
Estimated H-index: 2
(University of Pittsburgh),
Atsuko Kurosu3
Estimated H-index: 3
(University of Pittsburgh)
+ 2 AuthorsErvin Sejdić24
Estimated H-index: 24
(University of Pittsburgh)
Swallowing accelerometry is a noninvasive approach currently under consideration as an instrumental screening test for swallowing difficulties, with most current studies focusing on the swallowing vibrations in the anterior-posterior (A-P) and superior-inferior (S-I) directions. However, the displacement of the hyolaryngeal structure during the act of swallowing in patients with dysphagia involves declination of the medial-lateral (M-L), which suggests that the swallowing vibrations in the M-L d...
Published on May 1, 2016in Biomedical Signal Processing and Control 2.94
Joshua M. Dudik5
Estimated H-index: 5
(University of Pittsburgh),
James L. Coyle9
Estimated H-index: 9
(University of Pittsburgh)
+ 2 AuthorsErvin Sejdić24
Estimated H-index: 24
(University of Pittsburgh)
Swallowing disorders affect thousands of patients every year. Currently utilized techniques to screen for this condition are questionably reliable and are often deployed in non-standard manners, so efforts have been put forth to generate an instrumental alternative based on cervical auscultation. These physiological signals with low signal-to-noise ratios are traditionally denoised by well-known wavelets in a discrete, single tree wavelet decomposition. We attempt to improve this widely accepted...
Published on Apr 1, 2016in Dysphagia 3.03
Han Gil Seo8
Estimated H-index: 8
(Seoul National University Hospital),
Byung-Mo Oh13
Estimated H-index: 13
(Seoul National University Hospital),
Tai Ryoon Han18
Estimated H-index: 18
The purpose of this study was to investigate swallowing kinematics and explore kinematic factors related with penetration-aspiration in patients with post-stroke dysphagia. Videofluoroscopic images of 68 patients with post-stroke dysphagia and 34 sex- and age-matched healthy controls swallowing a thin liquid were quantitatively analyzed using two-dimensional motion digitization. The measurements included the movement distances and velocities of the hyoid and larynx, and the maximal tilt angles a...
Published on May 1, 2015in Nature Reviews Gastroenterology & Hepatology 23.57
Pere Clavé34
Estimated H-index: 34
,
Reza Shaker R59
Estimated H-index: 59
This Review highlightsthe progress that is being made in understanding the pathophysiology, prevalence and potential complications of both oropharyngeal dysphagia and oesophageal dysphagia, particularly in association with impaired physiology. The authors discuss the advances that are paving the way for a transdisciplinary field of deglutology.
Published on Nov 1, 2014in Otolaryngology-Head and Neck Surgery 2.31
Neil Bhattacharyya48
Estimated H-index: 48
(Harvard University)
ObjectiveTo determine the prevalence of dysphagia, reported etiologies, and impact among adults in the United States.Study DesignCross-sectional analysis of a national health care survey.Subjects and MethodsThe 2012 National Health Interview Survey was analyzed, identifying adult cases reporting a swallowing problem in the preceding 12 months. In addition to demographic data, specific data regarding visits to health care professionals for swallowing problems, diagnoses given, and severity of the...
Published on Oct 1, 2014in Archives of Physical Medicine and Rehabilitation 2.70
Daniel Chiung Jui Su1
Estimated H-index: 1
,
Kuo-Shu Yuan1
Estimated H-index: 1
+ 2 AuthorsWilly Chou8
Estimated H-index: 8
Interventions: Not Applicable. Main Outcome Measure(s): Performance-based clinical assessments of walking. Results: Item-bank development was accomplished using the first 2 qualitative stages of an 8-stage mixed-methods approach for assessment scale development (Velozo et. al, 2012). Stage 1 involved a comprehensive literature review to identify existing clinical assessment items that examine walking recovery. Walking recovery was defined as the ability to attain both steady-state walking and th...
Published on Apr 1, 2014in Dysphagia 3.03
Sonja M. Molfenter17
Estimated H-index: 17
(NYU: New York University),
Catriona M. Steele32
Estimated H-index: 32
(U of T: University of Toronto)
In this study we undertook careful analysis of 13 quantitative physiological variables related to oropharyngeal swallowing from a sample of 42 subacute patients referred for dysphagia assessment. Each patient underwent a videofluoroscopic swallowing examination in which they swallowed up to five boluses of 22 % w/v ultrathin liquid barium suspension administered by teaspoon. Our goal was to determine whether scores on 13 kinematic or temporal parameters of interest were independently associated ...
Published on Jan 1, 2014
Ming Wang8
Estimated H-index: 8
Generalized Estimating Equation (GEE) is a marginal model popularly applied for longitudinal/clustered data analysis in clinical trials or biomedical studies. We provide a systematic review on GEE including basic concepts as well as several recent developments due to practical challenges in real applications. The topics including the selection of “working” correlation structure, sample size and power calculation, and the issue of informative cluster size are covered because these aspects play im...
Published on Mar 1, 2011in Dysphagia 3.03
Sonja M. Molfenter17
Estimated H-index: 17
(Toronto Rehabilitation Institute),
Catriona M. Steele32
Estimated H-index: 32
(Toronto Rehabilitation Institute)
A literature review was conducted on hyoid and/or laryngeal displacement during swallowing in healthy populations according to several inclusion criteria. Anterior and superior displacement measures of both structures from previously published studies were compiled for meta-analysis. Results showed a large degree of variability across studies for each structure and plane of movement. Potential sources of variation were identified, including statistical, methodological, stimulus-related, and part...
Published on Jan 1, 2010in Gerontology 3.35
Bo Sung Kang1
Estimated H-index: 1
(SNU: Seoul National University),
Byung-Mo Oh13
Estimated H-index: 13
+ 3 AuthorsTai Ryoon Han18
Estimated H-index: 18
(SNU: Seoul National University)
Background: The age-related effects on various aspects of swallowing have been reported in studies on the temporal relationship between hyolaryngeal movement and bolus location, as
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