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Measuring Vallecular Volume on Flexible Endoscopic Evaluation of Swallowing: A Proof of Concept Study

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Abstract

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 mm2, 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.

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Authors and Affiliations

  1. Boston University School of Public Health, Talbot Building 715 Albany Street, Boston, MA, 02118, USA

    Kaylee Kim & Samantha Kennedy

  2. Boston University Medical Center, FGH Building 820 Harrison Ave, Boston, MA, 02118, USA

    Jessica M. Pisegna & Susan Langmore

  3. Boston University, Sargent College, 635 Commonwealth Ave, Boston, MA, 02215, USA

    Jessica M. Pisegna

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  1. Kaylee Kim
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  2. Jessica M. Pisegna
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  3. Samantha Kennedy
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  4. Susan Langmore
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Correspondence to Kaylee Kim.

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No potential conflict of interest was reported by the authors.

Research Involving Human Participants

MBS and FEES videos used in this study were from procedures already ordered for patient by physician (second author) as part of treatment. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kim, K., Pisegna, J.M., Kennedy, S. et al. Measuring Vallecular Volume on Flexible Endoscopic Evaluation of Swallowing: A Proof of Concept Study. Dysphagia 36, 96–107 (2021). https://doi.org/10.1007/s00455-020-10106-1

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  • DOI: https://doi.org/10.1007/s00455-020-10106-1

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