2.2 VFSS
We improved VFSS properly (D2RS, STEPHANIX, France), using
Iohexol Injection® (50ml: 17.5g, Yangtze River
Pharmaceutical Co, China) instead of barium. The patient stood in an
upright position, swallowed solid food (dry bread) about 1cm × 1cm ×
0.5cm which injected Iohexol Injection, semisolid food manufactured by
mixing Iohexol Injection and Resource Espesante®(Nestle, Germany) according to IDDSI level 4, and liquid food (Iohexol
Injection) in sequence. During the examination, the possible
compensatory position was chosen as same as modified GUSS. The
procedures of all cases were executed by two trained ENT specialists and
one experienced radiologist. Data were evaluated using a modified
penetration aspiration scale (MPAS) (Table.1) for partial laryngectomy,
already used and described in an earlier article, and the scores were
assessed for all cases.2, 3, 13 Higher scores mean
worse performance. In addition, Solid and semisolid food trails were
also both assessed in all cases, but once the score of Solid or
semisolid food trails was more than or equal to 5, the liquid food trail
would be forbidden.