CA One-Day Workshop Finland

Cervical Auscultation Articles to Review

Swallow-respiratory co-ordination

1. Butler S, Stuart A, Pressman H, Poage G, & Roche W. (2007) Preliminary Investigation of Swallowing Apnea Duration and Swallow/Respiratory Phase Relationships in Individuals with Cerebral Vascular Accident. Dysphagia, 22: 215-224.

• For normals (healthy adults), was the swallow apnea duration (SAD) shorter or longerthan for CVA patients – including those individuals who aspirated (IWA) and those individuals who did not aspirate (IWDNA).

• Other authors1 report the expiration-swallow-expiration pattern as occurring 79-82% of normal adults. In this study, what was the percentage of

The acoustics and physiology of swallow sounds

1. Moriniere S, Boiron M, Alison D, Makris P, & Beutter P. (2008) Origin of the sound components during pharyngeal swallowing in normal subjects. Dysphagia, 23: 267-273.
2. In this article the authors identified three sound components (SC) associated with the pharyngeal phase of swallowing. (a) List the terms / names given to these sounds. (b)What anatomical structures/ bolus position were the sounds associated with?

• Review the methodology of this study and answer;

(a) where was the listening device placed on the subject,

(b) where was the microphone located,

(c) how did this study identify individual sound components, and

(d) based on the information provided, could this study be replicatedexactly.

1. Leslie P, Drinnan M, Zammit-Maempel I, Coyle J, Ford G, & Wilson J. (2007) Cervical auscultation synchronized with images from endoscopy swallow evaluation. Dysphagia, 22: 290-298.
2. Review the methodology of this study and answer;

(a) where was the listening device placed on the subject,

(b) where was the microphone located,

(c) how did this study identify individual sound components, and

(d) based on the information provided, could this study be replicatedexactly.

• List 1-2 advantages and 1-2 disadvantages for using endoscopy with cervical auscultation in this study?

Evidence – validity and reliability

CLINICAL SWALLOW EXAMINATION (CSE)and CERVICAL AUSCULTATION

1. Bergström L, Svensson P, & Hartelius L. (2014). Cervical Auscultation as an Adjunct to the Clinical Swallow Examination: A Comparison with Fibreoptic Endoscopic Evaluation of Swallowing. International Journal of Speech-Language Pathology, 16(5): 517-528.

• List the sensitivity and specificity for detecting dysphagia using CA as reported in this study.
• List the sensitivity and specificity for detecting safety of swallow using CA as reported in this study.

• How long were each of the swallow clips (minimum to maximum length)?
• What length (in seconds) has been recommended for future studies?

INSTRUMENTAL ASSESSMENT

1. Kelly A, Leslie P, Beale T, Payten, & Drinnan M. (2006) Fibreoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity? Clinical Otolaryngology, 31: 425-432.

• For both instrumental assessments, what is the inter-rater and intra-rater reliability for pharyngeal residue as reported in this study?

6.Rao N, BradyL, Chaudhuri G, Donzelli J, & Wesling W. (2003) Gold-standard? Analysis of the videofluoroscopic and fiberoptic endoscopic swallow examinations. The Journal of Applied Research in Clinical and Experimental Therapeutics, 3: 89 – 96.

• When VFSS is used as the gold standard, what are the sensitivity values for FEES with,

(a)laryngeal penetration

(b) aspiration

(c) pharyngeal residue.

• When FEES is used as the gold standard, what are the sensitivity values for VFSS with,

(a)laryngeal penetration

(b) aspiration

(c) pharyngeal residue.

• List the agreements between the two tests for:

(a)laryngeal penetration

(b) aspiration

(c) pharyngeal residue.

References

1. Martin-Harris B, Brodsky M, Price C, Michel Y, & Walters B. (2003) Temporal coordination of pharyngeal and laryngeal dynamics with breathing during swallowing: single liquid swallows. Journal of Applied Physiology, 94: 1735-1743.