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[Dysphagia] Cervical Auscultation

  • Subject: [Dysphagia] Cervical Auscultation
  • From: scott-dailey at uiowa.edu (Dailey, Scott)
  • Date: Sat Jan 7 06:31:40 2006

I do use a stethoscope to listen to respiratory sounds and timing of swallow with infants. While I understand that there is not literature regarding this.  I am not using it to listen to quality and nature of swallowing/laryngeal sounds in how cervical auscultation is usually thought to be used.  I do not make conclusions based on swallowing sounds.  I am better able to count sucks before a swallow, number of swallows, and nature of cervical respiratory sounds before and after the swallow.  I become concerned about an infants airway protection during swallowing when respiratory wetness is heard during the feeding, when there is a discoordination of suck and swallow, or continued suck/swallow without breathing.  
My only thought about the pooling would be if the respiratory sounds become wet when listening following the swallow, however, you do not know exaclty where the wetness is coming from (material in larynx, pyriforms, vallecula, posterior pharyngeal wall.  Has your colleague told you what pooling sounds like?
Scott Dailey, MA, CCC-SLP
Speech-Language Pathologist
University of Iowa Hospitals and Clinics

	-----Original Message----- 
	From: dysphagia-bounces@b9.com on behalf of mdspeech@verizon.net 
	Sent: Sat 1/7/2006 12:26 AM 
	To: dysphagia@b9.com 
	Subject: [Dysphagia] Cervical Auscultation

	Despite growing clinical use, cervical auscultation suffers from a lack of research-based data. One of the strongest criticisms of cervical auscultation is that there has been little research to demonstrate how dysphagic swallowing sounds are different from normal swallowing sounds.
	That being said, exactly what valuable information are clinicians able to obtain when listening to someone swallow using a stethescope during cervical auscultation.
	So far I've only been able to find only a little subjective information pertaining to the timing of the apneic period during the swallow as well as clarity of the respirations. There are also reports of the perceptual identity of any attempts at laryngeal clearing or impeded airflow in the larynx.
	How does one translate and document this information into dysphagic vs non-dysphagic swallowing? Furthermore, is there anything else of value that is obtained by using this during a clinical bedside swallowing examination.
	I happen to work with fellow clinician who claims she can hear pooling in the pyriform sinuses with solids. This seems a little far fetched, but she seems hell bent on continuing to make these preposterous claims....I digress...
	I know that this topic has been covered before, but my review of the archives has yet to uncover any valuable information.
	Any help would be greatly appreciated.
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