Análise acústica do tempo de deglutição através do Sonar Doppler

Clinical and Acoustic Alterations of Swallowing in Children Exposed to Zika Virus during Pregnancy in a Cohort in Amazonas, Brazil: A Case Series Study

Oropharyngeal dysphagia (OD) is a swallowing disorder that involves difficulty in safely passing the food bolus from the oral cavity to the stomach. OD is a common problem in children with congenital Zika virus syndrome (CZS). In this case series, we describe the clinical and acoustic alterations of swallowing in children exposed to the Zika virus during pregnancy in a cohort from Amazonas, Brazil. From July 2019 to January 2020, 22 children were evaluated, 6 with microcephaly and 16 without microcephaly. The mean age among the participants was 35 months (±4.6 months). All children with microcephaly had alterations in oral motricity, mainly in the lips and cheeks. Other alterations were in vocal quality, hard palate, and soft palate. Half of the children with microcephaly showed changes in cervical auscultation during breast milk swallowing. In children without microcephaly, the most frequently observed alteration was in lip motricity, but alterations in auscultation during the swallowing of breast milk were not observed. Regarding swallowing food of a liquid and pasty consistency, the most frequent alterations were incomplete verbal closure, increased oral transit time, inadequacy in capturing the spoon, anterior labial leakage, and increased oral transit time. Although these events are more frequent in microcephalic children, they can also be seen in non-microcephalic children, which points to the need for an indistinct evaluation of children exposed in utero to ZIKV.

Accuracy of Acoustic Evaluation of Swallowing as a Diagnostic Method of Dysphagia in Individuals Affected by Stroke: Preliminary Analysis

After a stroke, more than half of the patients have some kind of disability, and dysphagia is frequently found. Cervical auscultation by Doppler sonar is an innovative technique with gain of credibility in the clinical evaluation of swallowing. To verify the diagnostic accuracy of Doppler sonar along with the DeglutiSom® software as an auxiliary method in the evaluation of oropharyngeal dysphagia in patients after stroke. The research is a cross-sectional, uncontrolled, blind, quantitative study with systematic random sampling. Patients from inpatient and outpatient units of a reference hospital with a stroke care unit were concomitantly submitted to both Doppler sonar and Fiberoptic Endoscopic Evaluation of Swallowing (FEES®). Seventy-three audio files collected from 26 patients through Doppler sonar were analyzed using DeglutiSom® software and confronted with the FEES® report, regarding three food consistencies offered to them during the exam. The study showed that the Doppler sonar correctly identified, among all the analyzed files, those that actually presented tracheal aspiration as well as it effectively identified patients who did not aspirate. The Youden index of 0.91 corroborates this information, showing a promising accuracy in detecting tracheal aspiration in the studied sample. The study evaluates the diagnostic accuracy of Doppler sonar, showing that it can be used as a valuable tool in the diagnosis of tracheal aspiration in patients after stroke. It is important to emphasize that the identification of residue by this method requires further studies. Also, larger sample size and more than one blind evaluator should be considered in future researches to increase the reliability of the proposed method.