Comparison of Analysis Techniques for Assessing Laryngeal Closure During the Swallow

College of Health Professions & Science, Froberg, Kendyl, Mentor, Oral Presentation, Outstanding Presentation, Pauloski, Barbara, Poster Presentation, School and College, School of Rehabilitation Sciences & Technology, Student

Kendyl Froberg, “Comparison of Analysis Techniques for Assessing Laryngeal Closure During the Swallow”
Mentor: Barbara Pauloski, Rehabilitation Sciences & Technology
Poster #65

The Purpose of this study is to compare three methods for analysis of videofluoroscopic swallow studies (VFSS), also known as the Modified Barium Swallow (MBS), a procedure used to diagnosis persons who might have problems swallowing. Several analysis methods are available, each with their own merits. The goal of this study is to determine the clinical yield from each method and compare their ability to discriminate safety of the swallow on a set of archived videofluoroscopic studies. These three techniques, the Modified Barium Swallow Impairment Profile (MBSImP), Penetration-Aspiration Scale (PAS), and kinematic analysis (movement dynamics) of arytenoid to epiglottis closure are used to assess safety of the swallow. PAS is a rating scale that characterizes the depth of invasion of swallowed material into the airway, a value of 1 indicating no invasion to a value of 8 indicating invasion below the vocal folds that is not expelled. Descriptive statistics for PAS ratings included median and range (maximum/minimum) values for each bolus consistency (thin liquid, nectar thick liquid, puree, and masticated cookie). Thin liquids were administered in volumes of 3, 5, 10, and 20 ml. Median PAS ratings by consistency are: PAS = 1 for thin liquid (range 1-7); PAS = 1 for nectar thick (range 1-2); PAS = 1 for puree (no range), and PAS=1 for cookie (range 1-2). PAS scores for thin liquid increased as bolus volume increased with a median PAS of 1 for 3 and 5 ml boluses and a median of 2 for 10 ml and 20 ml boluses. The deepest airway invasion (>=5) was observed on thin liquid boluses of 10 ml or larger. Measurement of the same swallows using MBSImP and laryngeal closure kinematics is ongoing. Inferential statistics will be used to determine agreement among the three assessment techniques to determine overall swallow safety.