Relation between acoustic analysis of swallowing and the presence of pharyngeal residue and penetration/aspiration in resistant hypertensive patients with obstructive sleep apnea
Mariana Pinheiro Brendim; Thalyta Georgia Vieira Borges; Carla Rocha Muniz; Flavia Rodrigues Ferreira; Elizabeth Silaid Muxfeldt
Abstract
Purpose: to evaluate the relationship between acoustic analysis of swallowing sounds and the presence of pharyngeal residue and penetration/aspiration detected by fiberoptic endoscopic evaluation of swallowing in resistant hypertensive patients with obstructive sleep apnea.
Methods: an observational study in which resistant hypertensive individuals diagnosed with obstructive sleep apnea participated through the all-night polysomnography exam. The participants underwent an acoustic analysis of swallowing sounds, using a Doppler sonar and simultaneously a fiberoptic endoscopic evaluation of swallowing. The acoustic parameters analyzed were initial frequency, initial intensity, first peak frequency, second peak frequency, final intensity and swallowing time. Independent samples of t-test and Mann-Whitney test were used for statistical analysis. The level of statistical significance adopted was 5%.
Results: eighty five participants with average age of 58.3±6.3 years were evaluated. There was a statistically significant difference between groups with and without pharyngeal residue, in relation to the following parameters of swallowing acoustic signal: initial frequency and intensity, second peak frequency, final intensity and swallowing time. Only 10 milliliters of pudding consistency showed a statistically significant difference in the second peak frequency of the acoustic signal of swallowing between groups with and without penetration/aspiration.
Conclusion: a relationship between measurements of swallowing acoustic signal and pharyngeal residue in this population was found, but not between swallowing sounds and penetration/aspiration.
Keywords
References
1. Carey RM, Calhoun DA, Bakris GL, Brook RD, Daugherty SL, Dennison-Himmelfarb CR et al. Resistant hypertension: detection, evaluation, and management: a scientific statement from the American Heart Association. Hypertension. 2018;72(5):e53-90.
2. Carnethon MR, Johnson DA. Sleep and resistant hypertension. Curr Hypertens Rep. 2019;21(5):34.
3. Mannarino MR, Di Filippo F, Pirro M. Obstructive sleep apnea syndrome. Eur J Intern Med. 2012;23(7):586-93.
4. Schindler A, Mozzanica F, Sonzini G, Plebani D, Urbani E, Pecis M et al. Oropharyngeal dysphagia in patients with obstructive sleep apnea syndrome. Dysphagia. 2014;29(1):44-51.
5. Oliveira LA, Fontes LH, Cahali MB. Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea. Braz. j. otorhinolaryngol. 2015;81(3):294-300.
6. Corradi AMB, Valarelli LP, Grechi TH, Eckeli AL, Aragon DC, Küpper DS et al. Swallowing evaluation after surgery for obstructive sleep apnea syndrome: uvulopalatopharyngoplasty vs. expansion pharyngoplasty. Eur Arch Otorhinolaryngol. 2018;275(4):1023-30.
7. Valarelli LP, Corradi AMB, Grechi TH, Eckeli AL, Aragon DC, Küpper DS et al. Cephalometric, muscular and swallowing changes in patients with OSAS. J Oral Rehabil. 2018;45(9):692-701.
8. Caparroz FA, Campanholo MAT, Sguillar DA, Haddad L, Park SW, Bittencourt L et al. A pilot study on the efficacy of continuous positive airway pressure on the manifestations of dysphagia in patients with obstructive sleep apnea. Dysphagia. 2019;34(3):333-40.
9. Valbuza JS, de Oliveira MM, Zancanella E, Conti CF, Prado LB, Carvalho LB et al. Swallowing dysfunction related to obstructive sleep apnea: a nasal fibroscopy pilot study. Sleep Breath. 2011;15(2):209-13.
10. Brady S, Donzelli J. The modified barium swallow and the functional endoscopic evaluation of swallowing. Otolaryngol Clin North Am. 2013;46(6):1009-22.
11. Santos R, Macedo Filho E. Sonar doppler as an instrument of deglutition evaluation. Int Arch Otorhinolaryngol. 2006;10(3):182-91.
12. Cagliari CF, Jurkiewicz AL, Santos RS, Marques JM. Doppler sonar analysis of swallowing sounds in normal pediatric individuals. Braz. j. otorhinolaryngol. 2009;75(5):706-15.
13. Soria FS, Silva RG, Furkim AM. Acoustic analysis of oropharyngeal swallowing using sonar doppler. Braz. j. otorhinolaryngol. 2016;82(1):39-46.
14. Lagos HN, Santos RS, Abdulmassih EM, Gallinea LF, Langone M. Characterization of swallowing sounds with the use of sonar doppler in full-term and preterm newborns. Int Arch Otorhinolaryngol. 2013;17(4):383-6.
15. Jerez RM. Evaluación funcional de la etapa faríngea de la deglutición utilizando sonar doppler. Revisión crítica de la literatura. Rev. logop. foniatr. audiol. 2017;37(1):38-42.
16. Patatas OHG, Gonçalves MIR, Chiari BM, Gielow I. Duration parameters of swallowing acoustic signals in subjects without complaints. Rev. Soc. Bras. Fonoaudiol. 2011;16(3):282-90.
17. Spadotto AA, Gatto AR, Cola PC, Silva RG, Schelp AO, Domenis DR et al. Components of the acoustic swallowing signal: preliminary study. J Soc Bras Fonoaudiol. 2012;24(3):218-22.
18. Hammoudi K, Boiron M, Hernandez N, Bobillier C, Morinière S. Acoustic study of pharyngeal swallowing as a function of the volume and consistency of the bolus. Dysphagia. 2014;29(4):468-74.
19. Honda T, Baba T, Fujimoto K, Goto T, Nagao K, Harada M et al. Characterization of swallowing sound: preliminary investigation of normal subjects. PLoS One. 2016;11(12):e0168187.
20. Youmans SR, Stierwalt JA. Normal swallowing acoustics across age, gender, bolus viscosity, and bolus volume. Dysphagia. 2011;26(4):374-84.
21. Lee J, Steele CM, Chau T. Classification of healthy and abnormal swallows based on accelerometry and nasal airflow signals. Artif Intell Med. 2011;52(1):17-25.
22. Jestrović I, Dudik JM, Luan B, Coyle JL, Sejdić E. The effects of increased fluid viscosity on swallowing sounds in healthy adults. Biomed Eng Online. 2013;12:90.
23. Abdulmassih EM, Teive HA, Santos RS. The evaluation of swallowing in patients with spinocerebellar ataxia and oropharyngeal dysphagia: a comparison study of videofluoroscopic and sonar doppler. Int Arch Otorhinolaryngol. 2013;17(1):66-73.
24. Madalozzo B, Aoki MCS, Soria F, Sampaio RS, Furkim AM. Acoustic analysis of swallowing time through doppler sonar. Rev. CEFAC. 2017;19(3):350-9.
25. Taveira KVM, Santos RS, Leão BLC, Stechman Neto J, Pernambuco L, Silva LK et al. Diagnostic validity of methods for assessment of swallowing sounds: a systematic review. Braz. j. otorhinolaryngol. 2018;84(5):638-52.
26. Hiss SG, Postma GN. Fiberoptic endoscopic evaluation of swallowing. Laryngoscope. 2003;113(8):1386-93.
27. Neubauer PD, Rademaker AW, Leder SB. The Yale Pharyngeal Residue Severity Rating Scale: an anatomically defined and image-based tool. Dysphagia. 2015;30(5):521-8.
28. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11(2):93-8.
29. Giraldo-Cadavid LF, Leal-Leaño LR, Leon-Basantes GA, Bastidas AR, Garcia R, Ovalle S et al. Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia. Laryngoscope. 2017;127(9):2002-10.
30. Wirth R, Dziewas R, Beck AM, Clavé P, Hamdy S, Heppner HJ et al. Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clin Interv Aging. 2016;11:189-208.
31. Patel JA, Ray BJ, Fernandez-Salvador C, Gouveia C, Zaghi S, Camacho M. Neuromuscular function of the soft palate and uvula in snoring and obstructive sleep apnea: a systematic review. Am J Otolaryngol. 2018;39(3):327-37.
32. Hamlet SL, Nelson RJ, Patterson RL. Interpreting the sounds of swallowing: fluid flow through the cricopharyngeus. Ann Otol Rhinol Laryngol. 1990;99(9 Pt 1):749-52.
33. Langmore SE. History of fiberoptic endoscopic evaluation of swallowing for evaluation and management of pharyngeal dysphagia: changes over the years. Dysphagia. 2017;32(1):27-38.
34. Hamlet SL, Patterson RL, Fleming SM, Jones LA. Sounds of swallowing following total laryngectomy. Dysphagia. 1992;7(3):160-5.
35. Ellis M, Pate M, Dorris H, Pearson Jr W, Brown J. Computational analysis of swallowing mechanics after surgery for obstructive sleep apnea. Ear Nose Throat J. 2018;97(4-5):122-7.
36. Cock C, Jones CA, Hammer MJ, Omari TI, McCulloch TM. Modulation of Upper Esophageal Sphincter (UES) relaxation and opening during volume swallowing. Dysphagia. 2017;32(2):216-24.
37. Shah F, Franklin KA, Holmlund T, Jäghagen EL, Berggren D, Forsgren S et al. Desmin and dystrophin abnormalities in upper airway muscles of snorers and patients with sleep apnea. Respir Res. 2019;20(1):31.
38. Wu ZH, Yang XP, Niu X, Xiao XY, Chen X. The relationship between obstructive sleep apnea hypopnea syndrome and gastroesophageal reflux disease: a meta-analysis. Sleep Breath. 2019;23(2):389-97.
39. Bognár L, Vereczkei A, Papp A, Jancsó G, Horváth Ö. Gastroesophageal reflux disease might induce certain-supposedly adaptive-changes in the esophagus: a hypothesis. Dig Dis Sci. 2018;63(10):2529-35.
40. Alkan Z, Demir A, Yigit O, Adatepe T, Kesici B, Kocak I et al. Cricopharyngeal muscle electromyography findings in patients with gastroesophageal reflux disease. Otolaryngol Head Neck Surg. 2012;147(2):295-301.
41. Vose A, Humbert I. "Hidden in Plain Sight": a descriptive review of laryngeal vestibule closure. Dysphagia. 2019;34(3):281-9.
Submitted date:
02/03/2020
Accepted date:
07/03/2020
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