This study will assess the use of ultrasound-a test that uses sound waves to produce
images-as a diagnostic tool for evaluating speech and swallowing.
The following categories of individuals may be eligible for this study: 1) healthy
volunteers between 20 and 85 years old with normal speech and hearing, 2) patients 6 to 85
years old with developmental neurological deficits in speech or swallowing, and 3) patients
with tumors of the oral cavity, pharynx or larynx being treated at the Greater Baltimore
Participants will undergo a 30-minute speech and oral motion evaluation, in which they
imitate sounds, words and oral movements while a speech pathologist evaluates their lip,
tongue and palate movements. They may also be asked to drink a small amount of water for
examination of swallowing function.
For the ultrasound examination, a 3/4-inch transducer (device for transmitting and receiving
sound waves) is placed under the participant's chin. While the transducer is in place, the
subject 1) repeats sounds and a series of syllables in several sequences, 2) swallows three
times with and without a small amount of water, and 3) swallows 3 teaspoons of non-fat
pudding. The ultrasound images are recorded on tape for later analysis.
Studies conducted using ultrasound imaging at the NIH, Departments of Rehabilitation
Medicine and Diagnostic Radiology, have demonstrated that ultrasound imaging can be used
reliably to study speech and swallowing impairments in a variety of conditions and diseases.
Since ultrasound is non-invasive with no reported bioeffects, it can be used repeatedly to
follow the progression of a disease. Ultrasound imaging of the oral cavity during speech
and swallowing allows easy visualization of the tongue/hyoid bone motion and transport of
the bolus during swallowing and tongue surface configuration during speech. Images can be
obtained in several planes for viewing muscular coordination and timing and specific
measures can be obtained from digitized video images. Thus it has widespread clinical
research implications for patients with disorders affecting the oral peripheral muscles,
salivary gland flow and the central nervous system control of speech and swallowing. While
ultrasound technology has been used extensively in Europe to evaluate tumors of the head and
neck, its use in this country has been marginal. We plan to compare ultrasound evaluation
of tumor staging, tumor volume, and tumor recurrence in patients with tumors of the larynx,
oral cavity and hypopharynx. Currently, this is accomplished by CT or MRI scanning
procedures. We plan to compare CT/MRI results with ultrasound to determine if this
non-invasive technique can be utilized reliably for diagnosis and tracking of oropharyngeal
Normal volunteers ages 21 to 85 may be asked to participate in a study of speech and
swallowing utilizing a traditional clinical examination of oral-motor performance. If the
subjects are without deficits in dental occlusion, speech articulation, tongue and lip
strength, tongue and lip mobility, palatal function and oral sensation they will be asked
to participate in an ultrasonic evaluation of tongue/hyoid interaction during swallowing
Children will be included if they are referred with a medical condition that affects the
oral pharyngeal phase of swallowing, voice production or laryngeal function and the
investigator needs to evaluate functional performance and safety for oral feeding.
Subjects aged 6 to 85 with diagnosed developmental, neuromotor, systemic, genetic,
neurologic, structural and post surgical dysfunction who have deficits in speech
(dysarthria) and/or swallow (dysphagia) may be asked to participate in this study of
ultrasonic imaging. Aging patients with and without dementia may also be studied.
Patients with Post Polio Syndrome, Polymyositis, Dermatomyositis, Toricollis, Cerebellar
Degeneration, Parkinson's disease, Progressive Supranuclear Palsy, ALS, Cystinosis, are
among the conditions of interest. Subjects with complaints of oral dryness, and patients
who have undergone mandibular and oral surgery may also be studied during swallowing.
Patients will be seen who are enrolled in NCI and NIDCD protocols for head and neck
Hearing impairment reported (above 40 db, bilaterally)
Palatal surgery or other restorative dental surgery
Radial neck dissection, glossectomy
Tumor or masses in neck or tongue
Cerebral vascular attack
Childhood articulation impairment