Boston University School of Public Health, Talbot Building 715 Albany Street, Boston, MA, 02118, USA.
Boston University Medical Center, FGH Building 820 Harrison Ave, Boston, MA, 02118, USA.
Dysphagia. 2021 Feb;36(1):96-107. doi: 10.1007/s00455-020-10106-1. Epub 2020 Apr 18.
Currently, no method exists to measure the size of pharyngeal and laryngeal structures on endoscopy. Imaging for dysphagia diagnostic techniques, for the most part, still relies on qualitative assumptions and cursory visual examinations to induce patients' swallowing safety and function. In this proof of concept study, we measured vallecular cavity volume using simultaneous modified barium swallows (MBS) and flexible endoscopic evaluation of swallowing (FEES). Similar to the three-dimensional image compilation fields of facial reconstruction, medical imagery, and forensic science, this proposed methodology combines the two-dimensional images yielded in FEES and MBS videos to calculate estimates of the valleculae in a 3D perspective. A tracking tool was used to measure distances on MBS, while endoscopic specifications were used to find distances on FEES. This combination of ratio measurements allowed for measurement on both the MBS and FEES. In a sample of n = 37 dysphagia patients referred for MBS/FEES studies, the mean distance from the tip of endoscope to the closest point of epiglottis was 25.38 mm, the mean vallecular area outlined on MBS video was 84.72 mm, the mean epiglottal width was 18.16 mm, and the mean vallecular volume was 1.55 mL. Future application could include tracking growth of tumors, glottic opening, volume of residue and tracking of any other important outcome involving movement, size, and targets of interest with higher precision.
目前，尚无方法可在内窥镜下测量咽和喉结构的大小。吞咽困难诊断技术的影像学在很大程度上仍然依赖于定性假设和粗略的目视检查来推断患者的吞咽安全性和功能。在这项概念验证研究中，我们使用同时进行的改良钡吞咽（MBS）和吞咽内窥镜评估（FEES）来测量会厌谷腔体积。类似于三维面部重建、医学成像和法医学的图像编译领域，该方法将 FEES 和 MBS 视频中产生的二维图像结合起来，从三维角度计算会厌谷的估计值。跟踪工具用于测量 MBS 上的距离，而内窥镜规格则用于在 FEES 上找到距离。这种比率测量的组合允许在 MBS 和 FEES 上进行测量。在 n=37 例因 MBS/FEES 研究而转诊的吞咽困难患者中，从内窥镜尖端到会厌最接近点的平均距离为 25.38mm，MBS 视频中勾画的会厌谷平均面积为 84.72mm，平均会厌宽度为 18.16mm，会厌谷平均体积为 1.55ml。未来的应用可能包括跟踪肿瘤的生长、声门的张开、残留量以及以更高的精度跟踪任何其他涉及运动、大小和目标的重要结果。
