The Penetration –Aspiration Scale: Adaptation to Open Partial Laryngectomy and Reliability Analysis

AbstractA standard for assessing swallowing function after open partial horizontal laryngectomy (OPHL) is still not established. The variability in the measures used to investigate swallowing functional outcomes after OPHL limits the communication among clinicians and the possibility to compare and combine results from different studies. The study aims to adapt the PAS to the altered anatomy after OPHLs using fiberoptic endoscopic evaluation of swallowing (FEES) and to test its reliability. To adapt the PAS, two landmarks were identified: the entry of the laryngeal vestibule and the neoglottis. Ninety patients who underwent an OPHL were recruited (27 type I, 31 type II and 32 type III). FEES was performed and video-recorded. Two speech and language therapists (SLTs) independently rated each FEES using the PAS adapted for OPHL (OPHL-PAS). FEES recordings were rated for a second time by both SLTs at least 15  days from the first video analysis. Inter- and intra-rater agreement was assessed using unweighted Cohen’s kappa. Overall, inter-rater agreement of the OPHL-PAS wask = 0.863, while intra-rater agreement wask = 0.854. Concerning different OPHL types, inter- and intra-rater agreement werek = 0.924 andk = 0.914 for type I,k = 0.865 andk = 0.790 for type II, andk = 0.808 andk = 0.858 for type III, respectively. The OPHL-PAS is a reliable scale to assess the invasion of lower airway during swallowing in patients with OPHL using FEES. The study...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research