Research Article  |   November 2011
The Utility of Pitch Elevation in the Evaluation of Oropharyngeal Dysphagia: Preliminary Findings
 
Author Affiliations & Notes
  • Georgia A. Malandraki
    William S. Middleton Memorial Veterans Hospital, Madison, WI
  • Jacqueline A. Hind
    William S. Middleton Memorial Veterans Hospital, Madison, WI
  • Ronald Gangnon
    University of Wisconsin—Madison
  • Jeri A. Logemann
    Northwestern University, Evanston, IL
  • JoAnne Robbins
    William S. Middleton Memorial Veterans Hospital, Madison, WI
  • Correspondence to Georgia A. Malandraki: malandraki@tc.columbia.edu
  • Editor: Carol Scheffner Hammer
    Editor: Carol Scheffner Hammer×
  • Associate Editor: Julie Liss
    Associate Editor: Julie Liss×
  • © 2011 American Speech-Language-Hearing AssociationAmerican Speech-Language-Hearing Association
Article Information
Swallowing, Dysphagia & Feeding Disorders / Special Populations / Research Article
Research Article   |   November 2011
The Utility of Pitch Elevation in the Evaluation of Oropharyngeal Dysphagia: Preliminary Findings
American Journal of Speech-Language Pathology, November 2011, Vol. 20, 262-268. doi:10.1044/1058-0360(2011/10-0097)
History: Received November 10, 2010 , Revised April 5, 2011 , Accepted May 22, 2011
 
American Journal of Speech-Language Pathology, November 2011, Vol. 20, 262-268. doi:10.1044/1058-0360(2011/10-0097)
History: Received November 10, 2010; Revised April 5, 2011; Accepted May 22, 2011
Web of Science® Times Cited: 1

Purpose: To evaluate the utility of a pitch elevation task in the assessment of oropharyngeal dysphagia.

Method: This study was a pilot prospective cohort study including 40 consecutive patients (16 male and 24 female) who were referred by their physician for a swallowing evaluation. Patients were evaluated with a noninstrumental clinical examination and a videofluoroscopic swallow study, and participated in a pitch elevation task during videofluoroscopic image acquisition. Relationships between pitch elevation measurements (acoustic and perceptual) and swallow parameters (penetration/aspiration and residue) were investigated.

Results: Results of this pilot study revealed that both maximum fundamental frequency (F0) and perceptual evaluation of pitch elevation independently significantly predicted Penetration-Aspiration Scale scores for thin liquid swallows (p = .01 and .03, respectively). Vocal range (average pitch to falsetto) was not sensitive in predicting likelihood of oropharyngeal dysphagia.

Conclusions: Findings indicate that reduced pitch elevation can be indicative of reduced airway protection and swallowing impairment in some dysphagia patients and may be a useful supplement to dysphagia screening and diagnosis. Further investigation is warranted to determine the optimal utility of this procedure for different diagnostic categories of patients.

Acknowledgments
This material is the result of work supported with resources and use of facilities at the William S. Middleton Memorial Veterans Hospital, Madison, WI. This article is Geriatric Research Education and Clinical Center (GRECC) Manuscript 2010-19. We wish to thank Abby Duane for her help with manuscript preparation; Kathryn Kleckner, Visual Information Specialist, for the illustration in Figure 1; and clinicians Jodi Hernandez, Stevie Marvin, and Molly Knigge for their help with subject recruitment.
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