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Association Between Diameter of Upper Esophageal Sphincter Maximal Opening and High-Resolution Cervical Auscultation Signal Features

Shu, Kechen (2019) Association Between Diameter of Upper Esophageal Sphincter Maximal Opening and High-Resolution Cervical Auscultation Signal Features. Master's Thesis, University of Pittsburgh. (Unpublished)

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High-resolution cervical auscultation (HRCA) has been proven to be an effective, non-invasive, portable and cost-efficient screening tool during dysphagia assessment. Previous publications have suggested that HRCA features differ between health individuals and patients with dysphagia. Correlations between HRCA features and swallowing kinematic events such as hyoid bone elevation, laryngeal elevation and upper esophageal sphincter (UES) opening have been tested and substantiated. Adequate duration and diameter of UES opening are essential to ensure normal swallowing, and yet the relationship between the diameter of maximal UES opening and HRCA signals remains unclear. In this study, we developed a standardized method to measure the diameter of maximal UES opening from video-fluoroscopic swallow studies (VFSS). We aimed to examine whether HRCA signal features are correlated to the diameter of maximal UES opening under hypothesis that they would be strongly associated. We measured the diameter of UES opening on VFSS recordings for approximately 5-7 consecutive frames around and including maximal hyoid excursion frame/s from 208 swallows of 23 patients with suspected dysphagia (16 males and 7 females). HRCA signals including swallowing sound, anterior-posterior (AP), superior-interior (SI) and medial-lateral (ML) vibration signals were collected by attaching a microphone and a tri-axis accelerometer to the neck of subjects. A statistical analysis was conducted between the maximal diameter of UES opening (among the selected 5-7 frames) normalized to a reference anatomical landmark to compensate for body differences between subjects and features extracted from segmented and pre-processed HRCA signals. Two different sets of signal segments were considered: whole swallow segments and UES opening segments. The results showed that various HRCA signal features were statistically significant to the normalized diameter of the maximal UES opening not only in the whole swallow segment but in the UES opening segment as well. Future studies may investigate the ability to predict the diameter of maximal UES opening by using HRCA signals. This would provide an alternative non-invasive tool to assess patients with dysphagia without using radiological examinations.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Shu, Kechenkes247@pitt.edukes2470000-0003-3885-9091
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairSejdić, Eesejdic@pitt.eduESEJDIC0000-0003-4987-8298
Committee MemberEl-Jaroudi,
Committee MemberAkcakaya,
Date: 10 September 2019
Date Type: Publication
Defense Date: 12 July 2019
Approval Date: 10 September 2019
Submission Date: 12 July 2019
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 71
Institution: University of Pittsburgh
Schools and Programs: Swanson School of Engineering > Electrical Engineering
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: High resolution cervical auscultation, swallowing sounds, dysphagia, upper esophageal sphincter, diameter of maximal UES opening
Date Deposited: 10 Sep 2019 14:26
Last Modified: 10 Sep 2019 14:26


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