Diagnostic Capabilities of Ultrasound on the Oropharynx and Larynx

Sonies, B

Abstract

The purpose of this project is to evaluate the ability of noninvasive ultrasound imaging to contribute to the diagnosis of impaired swallowing and speech and to evaluate the structure of the oropharynx (tongue, palate, oral muscles, hyoid) and larynx in normal and abnormal populations. Our recent focus has been to develop a procedure to evaluate the utilization of the quantitative components of ultrasound imaging to the study of the tongue. To this end, we have initiated a collaborative study with the Genetic Epidemiology Branch of the NCI to evaluate a group of patients with Beckwith-Weideman Syndrome (BWS). Patients with this syndrome have a major presenting feature of macroglossia (large tongues) along with a host of other genetic and structural abnormalities Hemihypertrophy of the limbs and body is another distinctive feature of the syndrome. We are utilizing ultrasound technology to obtain quantitative measurements of the internal structure of the tongue musculature from various imaging planes (coronal, sagittal, parasagittal, transverse). Measures of bilateral symmetry of the tongue are obtained to evaluate hemihypertrophy. In addition to ultrasound, these measures will be compared to photographs and superficial measurements of the tongue. An overall measurement scheme for the craniofacial area has also been developed for this study. We have conducted a pilot study on 4 families with BWS and are in the process of validating and revamping our ultrasound measurement procedures. This appears to be reasonable technique for quantifying lingual abnormality. Another project which is being developed is the use of ultrasound to evaluate the effects of treatment on tumor growth and to evaluate the reliability of ultrasound imaging in the detection of head and neck tumors, especially of the hypopharynx and larynx. We are collaborating with the otolaryngology, oncology and radiology departments of the Greater Baltimore Medical Center (GBMC) in the design and implementation of this project. All patients will be seen at GBMC and their taped studies will be analyzed in a blinded fashion at our C laboratory. We anticipate that if the project is successful, we will be able to improve the safety and reliability of the study of tumor treatment.