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An Investigation of the Post-laryngectomy Swallow Using Videofluoroscopy and Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Lookup NU author(s): Dr Michael Drinnan

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2018 The Author(s) This study investigates the post-laryngectomy swallow. Presence and degree of residue on the post-laryngectomy swallow as observed on videofluoroscopy and FEES is described. In addition, videofluoroscopy and FEES are assessed for reliability and inter-instrument agreement. 30 laryngectomy subjects underwent dysphagia evaluation using simultaneous videofluoroscopy and FEES. These were reviewed post-examination by three expert raters using a rating scale designed for this purpose. Raters were blinded to subject details, type of laryngectomy surgery, pairing of FEES and videofluoroscopy examinations and the scores of other raters. There was a finding of residue in 78% of videofluoroscopy ratings, and 83% of FEES ratings. Comparison of the tools indicated poor inter-rater reliability and poor inter-instrument agreement. Dysphagia is an issue post laryngectomy as measured by patient self-report and by instrumental evaluation. However, alternative dysphagia rating tools and dysphagia evaluation tools are required to enable accurate identification and intervention for underlying swallow physiology post laryngectomy.


Publication metadata

Author(s): Coffey MM, Tolley N, Howard D, Drinnan M, Hickson M

Publication type: Article

Publication status: Published

Journal: Dysphagia

Year: 2018

Volume: 33

Issue: 3

Pages: 369-379

Print publication date: 01/06/2018

Online publication date: 19/01/2018

Acceptance date: 07/11/2017

Date deposited: 30/01/2018

ISSN (print): 0179-051X

ISSN (electronic): 1432-0460

Publisher: Springer New York LLC

URL: https://doi.org/10.1007/s00455-017-9862-7

DOI: 10.1007/s00455-017-9862-7


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