Swallowing Sound Waveform and Its Clinical Significance : Evaluation Using Ultrasonography

Background: Cervical auscultation is a technique frequently used for the screening of dysphagia. However, this method is difficult to evaluate objectively and it is unclear how sound is generated during the swallowing process. The aim of this study was to analyze the waveform of swallowing sound and clarify the sound production process using recordings of swallowing sounds and ultrasound images (USI), performed simultaneously.
Materials and Methods: Commercial natural spring water and natural carbonated water were used in experiments 1 and 2, respectively. In experiment 1, a microphone was attached to the skin of the neck of 20 young participants and swallowing sounds were recorded and analyzed. In experiment 2, swallowing processes in three participants were recorded by a medical ultrasonography apparatus. The ultrasonic probe was placed on the skin over one of the thyroid cartilages or the thyroid gland.
Results: The swallowing sound wave (SSW) was divided into three sectional periods. The mean duration of the first, second, and third SSW was 210 ± 147 ms, 458 ± 113 ms, and 91 ± 61 ms, respectively. The mean intensity ratio of the first, second, and third SSW was 7.8 ± 5.2, 29.2 ± 16.5, and 5.8 ± 5.1, respectively. When the ultrasonic probe was placed on the skin over one of the thyroid cartilages, in the phase between the production of the second SSW and the silent period, the USI revealed an accumulation of swallowed material around the valleculae and oropharynx. In the silent period of the second SSW, the swallowed material accumulated around the hypopharynx. When the ultrasonic probe was placed on the skin over the thyroid gland, in the silent period of the second SSW, the USI revealed that the swallowed material had passed through esophagus.
Conclusion: Waveform and USI findings from this study suggest that swallowing sound can be divided into three sectional periods: an oral phase, a pharyngeal phase, and a repositioning phase.

内容要旨・審査要旨・論文本文の公開:
内容要旨 : LID201505281001.pdf
審査要旨 : LID201505281002.pdf
論文本文 : LID201509041001.pdf
本論文は，著者Tsuyoshi Hondaの学位論文として提出され，学位審査・授与の対象となっている。