Article  |   December 2011
Teledynamic Evaluation of Oropharyngeal Swallowing
 
Author Affiliations & Notes
  • Georgia A. Malandraki
    University of Illinois at Urbana–Champaign
  • Gary McCullough
    University of Central Arkansas, Conway
  • Xuming He
    University of Illinois at Urbana–Champaign
  • Elizabeth McWeeny
    University of Arkansas at Little Rock
  • Adrienne L. Perlman
    University of Illinois at Urbana–Champaign
  • Correspondence to Adrienne L. Perlman: aperlman@illinois.edu
  • Georgia A. Malandraki is now with Teachers College Columbia University, New York
    Georgia A. Malandraki is now with Teachers College Columbia University, New York×
  • Editor: Anne Smith
    Editor: Anne Smith×
  • Associate Editor: Caryn Easterling
    Associate Editor: Caryn Easterling×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Special Populations / Speech
Article   |   December 2011
Teledynamic Evaluation of Oropharyngeal Swallowing
Journal of Speech, Language, and Hearing Research, December 2011, Vol. 54, 1497-1505. doi:10.1044/1092-4388(2011/10-0284)
History: Received October 11, 2010 , Revised February 10, 2011 , Accepted April 27, 2011
 
Journal of Speech, Language, and Hearing Research, December 2011, Vol. 54, 1497-1505. doi:10.1044/1092-4388(2011/10-0284)
History: Received October 11, 2010; Revised February 10, 2011; Accepted April 27, 2011
Web of Science® Times Cited: 3

Purpose: The objective of the present investigation was to test the feasibility and clinical utility of a real-time Internet-based protocol for remote, telefluoroscopic evaluation of oropharyngeal swallowing.

Method: In this prospective cohort study, the authors evaluated 32 patients with a primary diagnosis of stroke or head/neck cancer. All patients participated in 2 separate fluoroscopic swallowing evaluations—one traditional on site and one telefluoroscopic off site—through the use of a telemedicine system. Agreement between sites was tested for 3 categories of variables: (a) overall severity of swallowing difficulty, (b) presence and extent of laryngeal penetration and aspiration as rated by the 8-point Penetration-Aspiration scale, and (c) treatment recommendations.

Results: Results showed overall good agreement in subjective severity ratings (κ = 0.636) and in Penetration-Aspiration scale ratings (mean absolute difference = 1.1 points) between the onsite and offsite clinicians. Agreement in treatment recommendations was moderate to high, ranging from 69.3% to 100%.

Conclusions: The present study supports the feasibility and clinical utility of a telemedicine system for evaluating oropharyngeal swallowing. Given the difficulty and expertise needed to complete such evaluations, this study offers promising clinical avenues for patients in rural, remote, and underserved communities and countries where expert swallowing specialists are not available.

Acknowledgments
This work was supported by National Institute on Deafness and Other Communication Disorders Grant RO1 DC005603-01A2, awarded to the last author. We thank Wee Witthawaskul, Juan Shen, and Jaime Olson for their great help in data acquisition and analysis.
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