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Automatic Detection and Analysis of Swallowing Sounds in Healthy Subjects and in Patients with Pharyngolaryngeal Cancer

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Abstract

Assessment of swallowing function is often invasive or involves irradiation. Analysis of swallowing sounds is a noninvasive method for assessment of swallowing but is not used in daily medical practice. Dysphagia could be the first symptom that occurs in head and neck cancer. This study evaluated a method for the automatic detection and analysis of swallowing sounds in healthy subjects and in patients with pharyngolaryngeal cancer. A smartphone application, developed for automatic detection and analysis of swallowing sounds was developed and tested in 12 healthy volunteers and in 26 patients with pharyngolaryngeal cancer. Swallowing sounds were recorded with a laryngophone during a standardized meal (100 mL mashed potatoes, 100 mL water, and 100 mL yogurt). Swallowing number and duration were noted; the results were compared to a standard swallowing sound analysis using the software AUDACITY®. There were no statistically significant differences in swallowing number or duration between the two analysis methods for the three types of foods in healthy volunteers and only for water in patients. In healthy volunteers, the results of our automatic analysis were comparable with those obtained with the standard analysis. However, a better discrimination of swallowing sounds is necessary for the algorithm to obtain reliable results with thicker food in patients with head and neck cancer.

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Abbreviations

HNC:

Head and neck cancer

ms:

Millisecond

mL:

Millilitre

SSD:

Swallowing sound duration

SN:

Swallowing number

FN:

False negative

FP:

False positive

Se:

Sensitivity

PPV:

Positive predictive value

TNM:

Tumoral classification according to tumor (T), nodular (N) or metastasis (M) criteria from the 8th edition of the American Joint Commission of Cancer

DT:

Detection threshold parameter

SR:

Sound richness parameter

EA:

End of analysis parameter

References

  1. Jean A. Brain stem control of swallowing: neuronal network and cellular mechanisms. Physiol Rev. 2001;81:929–69.

    CAS  PubMed  Google Scholar 

  2. Daniels SK, Brailey K, Priestly DH, Herrington LR, Weisberg LA, Foundas AL. Aspiration in patients with acute stroke. Arch Phys Med Rehabil. 1998;79:14–9.

    CAS  PubMed  Google Scholar 

  3. Mu L, Sobotka S, Chen J, Su H, Sanders I, Adler CH, et al. Altered pharyngeal muscles in Parkinson disease. J Neuropathol Exp Neurol. 2012;71:520–30.

    PubMed  Google Scholar 

  4. Power ML, Hamdy S, Singh S, Tyrrell PJ, Turnbull I, Thompson DG. Deglutitive laryngeal closure in stroke patients. J Neurol Neurosurg Psychiatry. 2007;78:141–6.

    CAS  PubMed  Google Scholar 

  5. Nguyen NP, Vos P, Moltz CC, Frank C, Millar C, Smith HJ, et al. Analysis of the factors influencing dysphagia severity upon diagnosis of head and neck cancer. Br J Radiol. 2008;81:706–10.

    CAS  PubMed  Google Scholar 

  6. Furkim AM, da Silva RG, Vanin G, Martino R. The association between temporal measures of swallowing with penetration and aspiration in patients with dysphagia: a meta-analysis. NeuroRehabilitation. 2019;44:111–29.

    PubMed  Google Scholar 

  7. Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003;124:328–36.

    PubMed  Google Scholar 

  8. Starmer H, Gourin C, Lua LL, Burkhead L. Pretreatment swallowing assessment in head and neck cancer patients. Laryngoscope. 2011;121:1208–11.

    PubMed  Google Scholar 

  9. Burnip E, Owen SJ, Barker S, Patterson JM. Swallowing outcomes following surgical and non-surgical treatment for advanced laryngeal cancer. J Laryngol Otol. 2013;127:1116–21.

    CAS  PubMed  Google Scholar 

  10. Francis DO, Weymuller EA, Parvathaneni U, Merati AL, Yueh B. Dysphagia, stricture, and pneumonia in head and neck cancer patients: does treatment modality matter? Ann Otol Rhinol Laryngol. 2010;119:391–7.

    PubMed  Google Scholar 

  11. Maclean J, Cotton S, Perry A. Post-laryngectomy: it’s hard to swallow. Dysphagia. 2009;24:172–9.

    PubMed  Google Scholar 

  12. 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;127:2002–10.

    PubMed  Google Scholar 

  13. Schatz K, Langmore SE, Olson N. Endoscopic and videofluoroscopic evaluations of swallowing and aspiration. Ann Otol Rhinol Laryngol. 1991;100:678–81.

    PubMed  Google Scholar 

  14. García Romero R, Ros Arnal I, Romea Montañés MJ, López Calahorra JA, Gutiérrez Alonso C, Izquierdo Hernández B, et al. Evaluation of dysphagia. Results after one year of incorporating videofluoroscopy into its study introduction. An Pediatr. 2018;89:92–7.

    Google Scholar 

  15. Lear CS, Flanagan JB, Moorrees CF. The frequency of deglutition in man. Arch Oral Biol. 1965;10:83–100.

    CAS  PubMed  Google Scholar 

  16. Mackowiak RC, Brenman HS, Friedman MH. Acoustic profile of deglutition. Proc Soc Exp Biol Med. 1967;125:1149–52.

    CAS  PubMed  Google Scholar 

  17. 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. https://doi.org/10.1371/journal.pone.0168187.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Dudik JM, Jestrović I, Luan B, Coyle JL, Sejdić E. A comparative analysis of swallowing accelerometry and sounds during saliva swallows. Biomed Eng. 2015;14:1–15.

    Google Scholar 

  19. Sazonov ES, Makeyev O, Schuckers S, Lopez-Meyer P, Melanson EL, Neuman MR. Automatic detection of swallowing events by acoustical means for applications of monitoring of ingestive behavior. IEEE Trans Biomed Eng. 2010;57:626–33.

    PubMed  Google Scholar 

  20. Fukuike C, Kodama N, Manda Y, Hashimoto Y, Sugimoto K, Hirata A, et al. A novel automated detection system for swallowing sounds during eating and speech under everyday conditions. J Oral Rehabil. 2015;42:340–7.

    CAS  PubMed  Google Scholar 

  21. Golabbakhsh M, Rajaei A, Derakhshan M, Sadri S, Taheri M, Adibi P. Automated acoustic analysis in detection of spontaneous swallows in Parkinson’s disease. Dysphagia. 2014;29:572–7.

    PubMed  Google Scholar 

  22. Morinière S, Beutter P, Boiron M. Sound component duration of healthy human pharyngoesophageal swallowing: a gender comparison study. Dysphagia. 2006;21:175–82.

    PubMed  Google Scholar 

  23. Morinière S, Boiron M, Alison D, Makris P, Beutter P. Origin of the sound components during pharyngeal swallowing in normal subjects. Dysphagia. 2008;23:267–73.

    PubMed  Google Scholar 

  24. Morinière S, Boiron M, Beutter P. Swallowing sound signal: description in normal and laryngectomized subjects. Ann Otolaryngol Chir Cervicofac. 2008;125:1–10.

    PubMed  Google Scholar 

  25. Morinière S, Boiron M, Brunereau L, Beutter P, Patat F. Pharyngeal swallowing sound profile assessed after partial and total laryngectomy. Dysphagia. 2011;26:366–73.

    PubMed  Google Scholar 

  26. 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;29:468–74.

    PubMed  Google Scholar 

  27. Takahashi K, Groher ME, Michi K. Methodology for detecting swallowing sounds. Dysphagia. 1994;9:54–62.

    CAS  PubMed  Google Scholar 

  28. Cichero JAY, Murdoch BE. Acoustic signature of the normal swallow: characterization by age, gender, and bolus volume. Ann Otol Rhinol Laryngol. 2002;111:623–32.

    PubMed  Google Scholar 

  29. Boiron M, Rouleau P, Metman EH. Exploration of pharyngeal swallowing by audiosignal recording. Dysphagia. 1997;12:86–92.

    CAS  PubMed  Google Scholar 

  30. Youmans SR, Stierwalt JAG. Normal swallowing acoustics across age, gender, bolus viscosity, and bolus volume. Dysphagia. 2011;26:374–84.

    PubMed  Google Scholar 

  31. 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.

    PubMed  PubMed Central  Google Scholar 

  32. Dudik JM, Coyle JL, Sejdić E. Dysphagia screening: contributions of cervical auscultation signals and modern signal-processing techniques. IEEE Trans Hum Mach Syst. 2015;45:465–77.

    PubMed  PubMed Central  Google Scholar 

  33. Taniwaki M, Kohyama K. Fast Fourier transform analysis of sounds made while swallowing various foods. J Acoust Soc Am. 2012;132:2478–82.

    PubMed  Google Scholar 

  34. Makeyev O, Lopez-Meyer P, Schuckers S, Besio W, Sazonov E. Automatic food intake detection based on swallowing sounds. Biomed Signal Process Control. 2012;7:649–56.

    PubMed  PubMed Central  Google Scholar 

  35. Jayatilake D, Ueno T, Teramoto Y, Nakai K, Hidaka K, Ayuzawa S, et al. Smartphone-based real-time assessment of swallowing ability from the swallowing sound. IEEE J Transl Eng Health Med. 2015;3:1–10.

    Google Scholar 

  36. Dudik JM, Kurosu A, Coyle JL, Sejdić E. Dysphagia and its effects on swallowing sounds and vibrations in adults. Biomed Eng Online. 2018;17:69.

    PubMed  PubMed Central  Google Scholar 

  37. Sarraf Shirazi S, Buchel C, Daun R, Lenton L, Moussavi Z. Detection of swallows with silent aspiration using swallowing and breath sound analysis. Med Biol Eng Comput. 2012;50:1261–8.

    PubMed  Google Scholar 

  38. Yamashita M, Yokoyama K, Takei Y, Furuya N, Nakamichi Y, Ihara Y, et al. Acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia. J Oral Rehabil. 2014;41:667–74.

    CAS  PubMed  Google Scholar 

  39. Pauloski BR, Rademaker AW, Logemann JA, Stein D, Beery Q, Newman L, et al. Pretreatment swallowing function in patients with head and neck cancer. Head Neck. 2000;22:474–82.

    CAS  PubMed  Google Scholar 

  40. Dong B, Biswas S. Analyzing breathing signals and swallow sequence locality for solid food intake monitoring. J Med Biol Eng. 2016;36:765–75.

    PubMed  PubMed Central  Google Scholar 

  41. Khalifa Y, Coyle J, Sedjic E. Non-invasive identification of swallows via deep-learning high resolution cervical auscultation recordings. Sci Rep. 2020;10:8704.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Seçil Y, Arıcı Ş, İncesu TK, Gürgör N, Beckmann Y, Ertekin C. Dysphagia in Alzheimer’s disease. Clin Neurophysiol. 2016;46:171–8.

    Google Scholar 

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Acknowledgements

We would like to thank the “Société française de carcinologie cervico-faciale” for its financial support. We would also like to thank “textcheck” for reviewing this article. For a certificate, please see: http://www.textcheck.com/certificate/ltDLWD.

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Authors and Affiliations

  1. ENT and Head and Neck Surgery, University Hospital of Tours, 2 Boulevard Tonnelé, 37044, Tours, France

    P. Rayneau, C. Rouf & S. Moriniere

  2. Polytech School, University of Tours, 64 Avenue Jean Portalis, 37200, Tours, France

    R. Bouteloup

  3. Tours Fundamental and Applied Computer Laboratory, University of Tours, CNRS 7002, 64 Avenue Jean Portalis, 37200, Tours, France

    P. Makris

  4. Francois-Rabelais University of Tours, University Hospital of Tours, 10 Boulevard Tonnelé, 37032, Tours, France

    S. Moriniere

  5. Service ORL Et Chirurgie Cervico-Faciale, CHU de Tours, 2 Boulevard Tonnelé, 37044, Tours, France

    P. Rayneau

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  1. P. Rayneau
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Correspondence to P. Rayneau.

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Rayneau, P., Bouteloup, R., Rouf, C. et al. Automatic Detection and Analysis of Swallowing Sounds in Healthy Subjects and in Patients with Pharyngolaryngeal Cancer. Dysphagia 36, 984–992 (2021). https://doi.org/10.1007/s00455-020-10225-9

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  • DOI: https://doi.org/10.1007/s00455-020-10225-9

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