J Korean Dysphagia Soc.  2022 Jan;12(1):50-58. 10.34160/jkds.2022.12.1.006.

Predicting Aspiration Using the Functions of Production and Quality of Voice in Dysphagic Patients

Affiliations
  • 1Department of Occupational Therapy, Rehabilitation Medicine, Asan Medical Center, Seoul, Korea
  • 2Department of Speech Pathology Therapy, Rehabilitation Medicine, Asan Medical Center, Seoul, Korea
  • 3Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 4Department of Rehabilitation Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 5Department of Occupational Therapy, Rehabilitation Medicine, The Catholic University of Korea, Eunpyeong St. Mary’s Hospital, Seoul, Korea

Abstract


Objective
This study aims to identify the usefulness of voice function in early screening for dysphagia. We sought to evaluate if screening tests through the functions of production and quality of voice were correlated with aspiration in dysphagic patients.
Methods
This study involved 55 participants who were referred to videofluoroscopic swallowing study (VFSS) for suspected dysphagia. Blinded examiners rated the voice production function (MVI, MPT) using a portable instrument and evaluated the quality of voice (jitter, shimmer, NHR) using Visi-pitch. Swallowing functions were also evaluated by utilizing the penetration-aspiration scale (PAS), American Speech-Language-Hearing Association (ASHA), National Outcome Measurement System (NOMS) swallowing scale and VDS. The patients were divided into two groups, the penetration group, and the aspiration group according to the PAS score. The difference in variables was analyzed using the Mann-Whitney U test between the two groups. The relationship between voice parameters and swallow-related parameters was determined using the Spearman correlation coefficient. In addition, the cut-off, sensitivity, and specificity of meaningful variables in silent aspiration were analyzed using the ROC curve analysis.
Results
The functions of production and quality of voice were found to be significantly different between the penetration and aspiration groups (P<.000). The PAS score was correlated with all parameters of the functions of production and quality of voice (P<.001). VDS was correlated with MVI, ASHA was correlated with MVI, and Shimmer (P<.001). The meaningful variables for silent aspiration were jitter and shimmer.
Conclusion
Through a clinical screening test, it may be possible to predict the difference between penetration and aspiration through the functions of production and quality of voice.

Keyword

Silent aspiration; Dysphagia; PAS; Screening test; Voice function
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