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.