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Correlation of Glottal Closure Using Concurrent Ultrasonography and Nasolaryngoscopy in Children: A Novel Approach to Evaluate Glottal Status

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Abstract

Objectives

Endoscopic procedures to assess aerodigestive symptoms by evaluating glottal motion are not practical in neonates because of small nares, respiratory difficulties, or additional stress. Our objective was to determine the temporal correlation between concurrent nasolaryngoscopy (NLS) and ultrasonography (USG) evaluation of glottal motion.

Methods

Simultaneous USG of the glottis was performed in 10 subjects (5 males, 5 females, age = 4.5 months to 7.1 years) that underwent diagnostic flexible outpatient NLS. The USG transducer was placed on the anterior neck at the level of the vocal cords. The video signals from NLS and USG were integrated and synchronized into real-time cine loops of 1-min duration.

Results

Frame-by-frame evaluation of 10,800 frames identifying glottal opening and closure time was compared between the two modalities by three observers and the timing of glottal closure was marked. Two investigators, blinded to NLS images, identified ultrasonographically determined glottal closure with 99% and 100% accuracy, and the mean probability of missing a closure frame was 0.007 (95% CI = 0.0008–0.024).

Conclusions

Temporal characteristics of glottal motion can be quantified by USG with perfect reliability and safety. This method can be useful in measuring the presence and the duration of laryngeal adduction.

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Authors and Affiliations

  1. Section of Neonatology, Pediatric Gastroenterology and Nutrition, Columbus Children’s Hospital, Columbus, Ohio, USA

    Sudarshan R. Jadcherla MD, FRCPI, DCH, Alankar Gupta MD, MS & Erin Stoner RN

  2. Department of Pediatric Radiology, Columbus Children’s Hospital, Columbus, Ohio, USA

    Brian D. Coley MD

  3. Department of Pediatric Otolaryngology, Columbus Children’s Hospital, Columbus, Ohio, USA

    Gregory J. Wiet MD, FACS, FAAP

  4. Department of Pediatrics, Ohio State University, Columbus, Ohio, USA

    Sudarshan R. Jadcherla MD, FRCPI, DCH & Brian D. Coley MD

  5. Departments of Otolaryngology and Biomedical Informatics, Ohio State University, Columbus, Ohio, USA

    Gregory J. Wiet MD, FACS, FAAP

  6. Section of Gastroenterology and Hepatology, Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Reza Shaker MD

  7. Section of Neonatology, Columbus Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43205, USA

    Sudarshan R. Jadcherla MD, FRCPI, DCH

Authors
  1. Sudarshan R. Jadcherla MD, FRCPI, DCH
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  2. Alankar Gupta MD, MS
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  3. Erin Stoner RN
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  4. Brian D. Coley MD
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  5. Gregory J. Wiet MD, FACS, FAAP
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  6. Reza Shaker MD
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Corresponding author

Correspondence to Sudarshan R. Jadcherla MD, FRCPI, DCH.

Additional information

The work presented in this article was done at Columbus Children’s Hospital and was supported in part by NIH grant (NIDDK) 7 RO3 61502-02.

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Jadcherla, S.R., Gupta, A., Stoner, E. et al. Correlation of Glottal Closure Using Concurrent Ultrasonography and Nasolaryngoscopy in Children: A Novel Approach to Evaluate Glottal Status. Dysphagia 21, 75–81 (2006). https://doi.org/10.1007/s00455-005-9002-7

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  • DOI: https://doi.org/10.1007/s00455-005-9002-7

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