Aghdam Mehran Alizadeh, Ogawa Makoto, Iwahashi Toshihiko, Hosokawa Kiyohito, Kato Chieri, Inohara Hidenori
Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Groningen University, Groningen, The Netherlands.
Dysphagia. 2017 Oct;32(5):617-625. doi: 10.1007/s00455-017-9803-5. Epub 2017 Apr 29.
The purpose of this study was to assess whether or not high frame rate (HFR) videos recorded using high-speed digital imaging (HSDI) improve the visual recognition of the motions of the laryngopharyngeal structures during pharyngeal swallow in fiberoptic endoscopic evaluation of swallowing (FEES). Five healthy subjects were asked to swallow 0.5 ml water under fiberoptic nasolaryngoscopy. The endoscope was connected to a high-speed camera, which recorded the laryngopharyngeal view throughout the swallowing process at 4000 frames/s (fps). Each HFR video was then copied and downsampled into a standard frame rate (SFR) video version (30 fps). Fifteen otorhinolaryngologists observed all of the HFR/SFR videos in random order and rated the four-point ordinal scale reflecting the degree of visual recognition of the rapid laryngopharyngeal structure motions just before the 'white-out' phenomenon. Significantly higher scores, reflecting better visibility, were seen for the HFR videos compared with the SFR videos for the following laryngopharyngeal structures: the posterior pharyngeal wall (p = 0.001), left pharyngeal wall (p = 0.015), right lateral pharyngeal wall (p = 0.035), tongue base (p = 0.005), and epiglottis tilting (p = 0.005). However, when visualized with HFR and SFR, 'certainly clear observation' of the laryngeal structures was achieved in <50% of cases, because all the motions were not necessarily captured in each video. These results demonstrate the use of HSDI in FEES makes the motion perception of the laryngopharyngeal structures during pharyngeal swallow easier in comparison to SFR videos with equivalent image quality due to the ability of HSDI to depict the laryngopharyngeal motions in a continuous manner.
本研究的目的是评估在纤维喉镜吞咽功能评估（FEES）中，使用高速数字成像（HSDI）录制的高帧率（HFR）视频是否能改善对喉咽结构在咽期吞咽时运动的视觉识别。五名健康受试者在纤维鼻咽喉镜检查下吞咽0.5毫升水。内窥镜连接到一台高速摄像机，该摄像机在整个吞咽过程中以4000帧/秒（fps）的速度记录喉咽视图。然后将每个HFR视频复制并下采样为标准帧率（SFR）视频版本（30 fps）。十五名耳鼻喉科医生以随机顺序观察所有HFR/SFR视频，并根据反映在“变白”现象之前对喉咽结构快速运动的视觉识别程度的四点有序量表进行评分。与SFR视频相比，以下喉咽结构的HFR视频得分显著更高，表明可见性更好：咽后壁（p = 0.001）、左咽壁（p = 0.015）、右咽侧壁（p = 0.035）、舌根（p = 0.005）和声门倾斜（p = 0.005）。然而，当用HFR和SFR可视化时，在不到50%的病例中能实现对喉部结构的“肯定清晰观察”，因为并非每个视频都能捕捉到所有运动。这些结果表明，在FEES中使用HSDI，与具有同等图像质量的SFR视频相比，由于HSDI能够连续描绘喉咽运动，使得在咽期吞咽时对喉咽结构的运动感知更容易。
