[A preliminary study on the assessment of swallowing function after supracricoid partial laryngectomy].
OBJECTIVE
To investigate a reliable and easy assessment method for swallowing function by evaluating objectively the recovery process of swallowing function in patients six months after supracricoid partial laryngectomy.


METHODS
The swallowing function of patients who underwent supracricoid partial laryngectomy was evaluated six months after operation in Nanfang Hospital of Southern Medical University between January 2013 and February 2014 with two methods, the modified barium swallow (MBS) and fiberoptic endoscopic evaluation of swallowing (FEES), combined with modified penetration aspiration scale (MPAS). Furthermore, the feasibility, reliability and accuracy of these two methods were compared.


RESULTS
Eleven patients were enrolled. MPAS equals score 1 for solid food, semiliquid food, and liquid food was defined as a criteria of normal swallowing function. By MBS evaluation, the numbers of patients with normal swallowing function were two cases at day 16-30 postoperation, two cases at day 31-45 postoperation, five cases at day 46-90 postoperation, and six cases at day 91-180 postoperation, respectively. By FEES evaluation, the above numbers were three cases, four cases, six cases and eight cases, respectively. When the aspiration was minimal and ejected completely and MPAS was less than or equal to score 4 for solid food, semiliquid food, and liquid food, the gastric tube could be removed. According to this standard, the gastric tube was removed in all cases, and the mean time was (21.7 ± 9.8) days. A good correlation was obtained between these two methods when evaluating solid and semiliquid food, and the Kappa values were 0.802 and 0.844, respectively. However, a little agreement was obtained between these two methods when evaluating liquid food, and the Kappa value was 0.529.


CONCLUSIONS
Patients who underwent supracricoid partial laryngectomy could restore good swallowing function in six months after the operation. Both the MBS and FEES are valuable procedures for evaluating objectively the swallowing function in patients after supracricoid partial laryngectomy. The FEES is much better than MBS, because FEES is a simple operation performed alone by otolaryngologists with no radiation.
Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China.
Zhiming
Z
Zhong
Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China.
Wendong
W
Tian
Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China.
Xiong
X
Liu
Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China.
Juan
J
Lu
Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China.
Fangfang
F
Zeng
Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China.
Huaihong
H
Chen
Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China. Email:li321162@qq.com.
Xiangping
X
Li
D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007825:Laryngectomy; D011184:Postoperative Period; D015203:Reproducibility of Results