Acoustic and electroglottographic voice characteristics in chronic cough and paradoxical vocal fold movement

Objective: Chronic cough (CC) and paradoxical vocal fold movement (PVFM) may be associated with voice problems. Objective acoustic and electroglottographic (EGG) measures have the capacity to delineate these vocal characteristics. This study investigated acoustic and EGG voice features of CC and PVFM. Patients and Methods: Acoustic and EGG findings were compared among 5 groups of participants. The first 3 groups, CC (n = 56), PVFM (n = 8) and combined CC-PVFM (n = 55), included individuals with cough and respiratory symptoms that persisted despite medical treatment. Groups 4 and 5 included individuals with muscle tension dysphonia (n = 25) and healthy controls (n = 27). Results: Participants with CC/PVFM recorded reduced phonation times (p<0.001), greater jitter (p<0.001), reduced harmonic to noise ratio (p = 0.001), reduced phonation range (p = 0.007) and shorter closed phase of vocal fold vibration (p = 0.006) in comparison to healthy controls. Females with CC had reduced fundamental frequency in connected speech (p = 0.009). There was consistent overlap between the participants with CC and those with PVFM. Duration of closed phase and fundamental frequency were lower in the participants with CC and PVFM than in those with muscle tension dysphonia. Conclusion: These results confirm abnormalities in acoustic and EGG voice features in CC and PVFM

O uso da ausculta cervical na inferência de aspiração traqueal em crianças com paralisia cerebral The use of cervical auscultation in tracheal aspiration in children with cerebral palsy

OBJETIVO: comparar a detectabilidade da ausculta cervical na avaliação clínica com a comprovação da aspiração na videofluoroscopia da deglutição em crianças com paralisia cerebral tetraparética espástica com disfagia orofaríngea. MÉTODOS: estudo retrospectivo com análise de 101 prontuários de crianças, na faixa etária de 1 a 12 anos, pertencentes a uma instituição, com diagnóstico de paralisia cerebral tetraparética espástica e que foram encaminhadas e avaliadas por equipe interdisciplinar. Foi realizada anamnese com avaliação clínica da alimentação com ausculta cervical e videofluoroscopia da deglutição. RESULTADOS: os resultados estatísticos mostraram que há relação significante entre a ausculta cervical positiva e a penetração ou aspiração laríngea constatada na videofluoroscopia da deglutição e que a ausculta cervical negativa está mais associada à não penetração/aspiração. CONCLUSÃO: concluiu-se que a ausculta cervical pode ser utilizada para inferência do risco de aspiração e, portanto, como alerta para atuação precoce nessa população, além da vantagem de ser um método não invasivo.<br>PURPOSE: to compare the efficacy of cervical auscultation during the clinical evaluation with the confirmation of aspiration in the videofluoroscopy of deglutition in oropharyngeal dysphagic children with tetraparetic cerebral palsy. METHODS: retrospective study with analysis of 101 notes of children, between 1 and 12-year old, enrolled in one institution, with the diagnosis of cerebral palsy spastic quadriplegia and referred and evaluated by interdisciplinary team. Clinical history, clinical evaluation of feeding with cervical auscultation and videofluoroscopy of deglutition were performed. RESULTS: the statistical results showed significance between positive cervical auscultation and laryngeal penetration or aspiration during the videofluoroscopy of deglutition and a negative cervical auscultation is correlated to non penetration/aspiration. CONCLUSION: cervical auscultation can be used as an inference to risk of aspiration, therefore a sign to early intervention in this population. Furthermore, it is a non-invasive method

Adult Dysphagia Assessment in the UK and Ireland: Are SLTs Assessing the Same Factors?

This is the first study to examine dysphagia assessment practices of UK/Ireland speech and language therapists. The aims were to (1) examine practice patterns across clinicians, (2) determine levels of consistency in practice, and (3) compare practices of clinicians in the UK/Ireland with those previously reported of clinicians in the United States. A questionnaire, developed for earlier U.S. research, was adapted following a pilot study. The resulting email survey was completed by 296 speech and language therapists working with dysphagic adults. Respondents were asked to rate how frequently they use 31 components of a clinical dysphagia examination. Consistency was determined by calculating the percentage of respondents who agreed on frequency of use. Low frequency of use was reported for four components: trials with compensatory techniques, obtain patient’s drug history, assessment of speech articulation/intelligibility, and screening/assessment of mental abilities. Variability among clinicians was high, with inconsistency observed for 6/31 components (19%) and high consistency for only 10/31 (32%). Results were compared with data from the earlier U.S. study. Notable differences in practice were observed for five components: cervical auscultation, trials with compensatory techniques, gag reflex, assessment of sensory function, and screening/assessment of mental abilities. Inconsistency among UK/Ireland clinicians was higher than in the comparator U.S. study. The clinical implications of these findings are discussed