PubMed · 5765901
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P Y Ertel, M Lawrence, W Song. How to test stethoscopes.. https://pubmed.ncbi.nlm.nih.gov/5765901/
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This clinical study was performed to evaluate the advantages and limitations of 3 acoustic stethoscopes and 3 electronic stethoscopes. It shows that it is possible to design a new electronic stethoscope by considering the advantages of both the acoustic and electronic stethoscopes.
A hypothetical discussion of the cause of swallowing sounds is presented. It is suggested that the pharynx contains a number of valves and pumps that produce reverberations within the pharynx to generate swallowing sounds. As heart sounds are propagated via vibration of muscles and valves, it is further suggested that an analogy exists between the generation of heart sounds and swallowing sounds. This new theory is known as the cardiac analogy hypothesis. The inability of the current literature to explain the cause of swallowing sounds is seen to limit the diagnostic potential of cervical auscultation for dysphagia assessment. Future investigators are encouraged to prove or disprove the cardiac analogy hypothesis.
OBJECTIVE: To investigate acoustic assessment of complex structural anomalies in cleft lip and palate associated nasal deformities and its impact on the planning of corrective rhinosurgery. PATIENTS: Twenty-three consecutive patients with unilateral CL(P) during routine consultations, three of them prior to corrective surgery. INTERVENTION: Acoustic measurements of the nasal airway crosssectional area were obtained for both nasal cavities. The size of isthmus area and isthmus location as well as the nasal volume and decongestion capacity in various regions of interest were determined. RESULTS: Obstructions in the area of the nasal valve (< 0.4 cm2) were detected in 85% of the patients on the cleft side, but only 15% on the contralateral side. Severe mucosal hypertrophy was a common finding on the cleft side with a significantly higher capacity of decongestion, especially in the posterior region of the nasal cavity (P < 0.02). A second stenosis located behind the physiological isthmus was found in 16 patients. CONCLUSION: Acoustic rhinometry is a noninvasive, objective method. It measures the degree and the exact location of airway obstructions. Apart from the equipment, the only prerequisite is a cooperative patient. The measurement has direct therapeutic consequences. If the exact cause and location of airway stenosis are known, it is easier to adapt the corrective surgical procedures to suit the individual patient. The decision in favour of additional therapeutic measures can be made on a more rational basis to prevent residual airway problems postoperatively. Preoperative acoustic rhinometry offers valuable information concerning the severity and location of nasal airway obstructions and thus proves to be a helpful tool in the planning of corrective operative measures.