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Modified Gugging Swallowing Screen: A new evaluation tool for swallowing function in patients with partial laryngectomy before oral feeding. A single center retrospective study
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  • Qi Huang,
  • Yihua Gui,
  • Quanjie You,
  • Yi Shen,
  • Yan Zhou,
  • Kan Zhao,
  • Zhenzhen Wang,
  • Rujiao Xie,
  • Zhenhua Wu
Qi Huang
Ningbo Medical Treatment Centre Li Huili Hospital
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Yihua Gui
Ningbo Medical Treatment Centre Li Huili Hospital
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Quanjie You
Ningbo Medical Treatment Centre Li Huili Hospital
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Yi Shen
Ningbo Medical Treatment Centre Li Huili Hospital
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Yan Zhou
Ningbo Medical Treatment Centre Li Huili Hospital
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Kan Zhao
Ningbo Medical Treatment Centre Li Huili Hospital
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Zhenzhen Wang
Ningbo Medical Treatment Centre Li Huili Hospital
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Rujiao Xie
Ningbo Medical Treatment Centre Li Huili Hospital
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Zhenhua Wu
Ningbo Medical Treatment Centre Li Huili Hospital
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Abstract

Abstract Objectives: Dysphagia is a common complication after partial laryngectomy. Most of the evaluation tools are not suitable for swallowing assessment of patients after partial laryngectomy. Our aim was to introduce modified Gugging Swallowing Screen (GUSS) and evaluate the reliability and validity of it in patients with partial laryngectomy before oral feeding. Design: A single center retrospective study. Settings, participants and main outcome measures: From September 2018 to February 2020, 40 hospitalized patients with partial laryngectomy due to laryngeal carcinoma were included in this study. Modified GUSS and videofluorospic swallowing study (VFSS) were carried out to evaluate swallowing function respectively on the day before oral feeding. Two independent trained nurses evaluated all patients for interrater reliability of modified GUSS. The results of modified GUSS were compared with VFSS for predictive validity. The VFSS results of solid、semisolid and liquid food were compared for content validity. Spearman’s rank correlation coefficient、Kappa statistics and Wilcoxon signed rank tests were used for analysis. Results: Modified GUSS had substantial to excellent interrater reliability for all classification categories (rs=0.961, P<0.01; κ=0.600 to 1.000, P<0.01), and had excellent consistency and predictive validity compared with VFSS (rs=-0.931, P<0.01; κ=0.800 to 1.000, P<0.01). The results of modified GUSS and the days from starting oral intake to removing gastric tube were demonstrated to have substantially negative correlation (rs= -0.664, P<0.01). The risk of aspiration of swallowing solid food was lower than that of swallowing semisolid food (P<0.01), and the risk of aspiration of swallowing semisolid food was lower than that of swallowing liquid food (P<0.01). Conclusions: We modified GUSS to make it suitable for patients with partial laryngectomy successfully. Moreover, the screen was proved as an evaluation tool that had good reliability and validity for assessment of swallowing function and risks of aspiration in patients with partial laryngectomy before oral feeding.