Akustische Signale in der Diagnostik der pharyngealen Dysphagie

Aspiration pneumonia caused by postapoplectic pharyngeal dysphagia is a frequent and potentially lethal complication of stroke. Diagnosis is currently established by video endoscopy or videofluoroscopy. Analysis of swallowing sounds as a bedside method may allow earlier diagnosis and improve follow-up. Swallowing sounds recorded by a neck microphone from patients of three groups were compared: Patients with stroke and dysphagia, patients with stroke but without dysphagia and a control group. Analysis included the sound dimensions frequency, duration and volume in correlation with the results of a video endoscopy. A total of 66 patients and controls were included into the trial: 24 patients with stroke and dysphagia, 18 with stroke but without dysphagia, and 24 controls. The total signal duration was significantly increased for patients with dysphagia against controls (978.0 ms vs. 616.6 ms, respectively). Comparison between both stroke groups (with and without dysphagia) missed significance. A signal length of more than one second always indicated severe dysphagia in the dataset. The trial demonstrates significant difference between healthy controls and patients with postapoplectic dysphagia. A trend towards according differences between stroke patients with and without dysphagia was not significant. Prospective studies will therefore have to show the value of acoustic analysis as a screening method