American Journal of Speech-Language Pathology Vol.20 262-268 November 2011. doi:10.1044/1058-0360(2011/10-0097)
© American Speech-Language-Hearing Association
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Research Article

The Utility of Pitch Elevation in the Evaluation of Oropharyngeal Dysphagia: Preliminary Findings

Georgia A. Malandrakia,,b,,c
Jacqueline A. Hinda,,b
Ronald Gangnonb
Jeri A. Logemannd
JoAnne Robbinsa,,b
a William S. Middleton Memorial Veterans Hospital, Madison, WI
b University of Wisconsin—Madison
c Teachers College, Columbia University, New York, NY
d Northwestern University, Evanston, IL

Correspondence to Georgia A. Malandraki: malandraki{at}tc.columbia.edu

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.

Key Words: swallowing, voice, cricothyroid muscle, aspiration, pitch elevation


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