연하장애 환자의 흡인을 선별하기 위한 음성기능 검사
Predicting Aspiration Using the Functions of Production and Quality of Voice in Dysphagic Patients
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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 aspira-tion 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 swal-low-related parameters was determined using the Spearman correlation coefficient. In addition, the cut-off, sensi-tivity, 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 pen-etration and aspiration groups (P＜.000). The PAS score was correlated with all parameters of the functions of pro-duction 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.
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 aspira-tion 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 swal-low-related parameters was determined using the Spearman correlation coefficient. In addition, the cut-off, sensi-tivity, 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 pen-etration and aspiration groups (P＜.000). The PAS score was correlated with all parameters of the functions of pro-duction 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.
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