Introduction
Dysphagia is a common complication after partial laryngectomy.
Persistent and severe dysphagia can lead to recurrent aspiration
pneumonia, hyponutrition, and cachexia.1-4 The
solutions for those critical situations can be gastrostomies or total
laryngectomies. Thus, it is very important to evaluate the swallowing
function of patients with partial laryngectomy in early stage,
especially before oral feeding.5 Swallowing assessment
before oral feeding has been a standard of care for years. However, most
of the tools only include the test of liquid swallowing, which can not
fully reflect the swallowing situation of various characters of
food.6 Therefore, most of the tools are not suitable
for swallowing evaluation of patients after partial laryngectomy.
The main diagnostic tool recognized as the gold standard for identifying
dysphagia is the videofluorospic swallowing study
(VFSS).7 And the fiberoptic endoscopic examination of
swallowing (FEES) compares well with the results from
VFSS.8 However, they have several limitations
respectively, such as radiation, complex processes.9Michaela Trapl developed a simple and convenient bedside evaluation tool
of swallowing function (Gugging Swallowing Screen, GUSS) in stroke
patients.6 It was demonstarted as a quick and reliable
method to identify stroke patients with dysphagia and aspiration risk.
This new instrument allowed a graded assessment of the patient’s
swallowing abilities, measured the severity of dysphasia, and enabled
dietary recommendations. The good reliability and validity of the
Chinese version of the scale in stroke patients had also been
demonstrated in China.10 As far as we know, GUSS has
not been used to assess swallowing function after partial laryngectomy.
Based on the clinical practicability of the GUSS, we designed this
study. Furthermore, we modified the GUSS to be more suitable for
patients with partial laryngectomy, and analyzed the reliability and
validity of modified GUSS to demonstrate whether the evaluation effect
on swallowing function of patients with partial laryngectomy before oral
feeding in early postoperative stage is definite.