Validity and reliability of the Group for Learning Useful and Performant Swallowing (GLUPS) tool

INTRODUCTION

To validate the Group for Learning Useful and Performant Swallowing (GLUPS), a clinical tool dedicated to videofluoroscopy swallowing study (VFSS).

METHODS

Forty-five individuals were recruited from January 2022 to March 2023 from the Department of Otolaryngology Head and Neck Surgery of University Hospital Saint-Pierre (Brussels, Belgium). Subjects underwent VFSS, which was rated with GLUPS tool by two blinded otolaryngologists and one speech-therapist. VFSS were rated twice with GLUPS within a 7-day period to assess test-retest reliability.

RESULTS

Twenty-four patients and twenty-one controls completed the evaluations. The internal consistency (α = 0.745) and the test-retest reliability (rs = 0.941; p = 0.001) were adequate. GLUPS reported a high external validity regarding the significant correlation with the Penetration-Aspiration Scale (rs = 0.551; p = 0.001). Internal validity was adequate, because GLUPS score was significant higher in patients compared to controls (6.21 ± 4.42 versus 2.09 ± 2.00; p = 0.001). Interrater reliability did not report significant differences in the GLUPS sub- and total score among the independent judges. The mean GLUPS score of individuals without any evidence of VFSS abnormalities was 2.09/23 (95% CI  1.23-2.95), which supported that a GLUPS score ≥ 3.0 is suggestive of pathological VFSS.

CONCLUSIONS

GLUPS is a clinical instrument documenting the abnormal findings of oral and pharyngeal phases at the VFSS. GLUPS demonstrated high reliability and excellent criterion-based validity. GLUPS may be used in clinical practice for the swallowing evaluation at the VFSS.

Chronic Course, Weaning, and Awareness of Patients With Reflux Toward Proton Pump Inhibitor Therapy

OBJECTIVES

To assess the feasibility of middle-term proton pump inhibitor (PPI) weaning in patients with laryngopharyngeal reflux (LPR) and evaluate patient awareness of PPI adverse events.

METHODS

We conducted a cross-sectional study of 100 LPR patients treated with an association of diet, PPIs, and alginate. Patients were followed from September 2016 to May 2020. At the end of the initial 3-to-6 months therapeutic period, LPR patients were weaned from PPIs and instructed to respect diet and stress management over the long-term. The 3-year symptom recurrence rate, PPI use, and patient awareness of PPI adverse events were assessed.

RESULTS

Sixty-seven patients completed the evaluation. Twenty-seven patients (40.3%) reported a chronic course of LPR-symptoms, requiring chronic or occasional PPI use. LPR symptom recurrence occurred 1-to-2 or 3-to-5 times yearly in 8.9% and 20.9% of patients, respectively. Recurrences were managed by short-term diet, alginate, or PPI intake. The remaining patients (29.9%) did not report middle-term LPR recurrence. The 3-year weaning rate of occasional or chronic use of PPIs was 64.2%. Among participants, 26.8% were aware of PPI-related adverse events, most frequently through physicians (33%), online sources (17%), and friends or family (17%). Nonresponder patients were significantly more aware of PPI adverse events than responders (P = 0.029). PPI-attributed adverse events occurred in 29.8% of patients.

CONCLUSION

Sixty-four percent of LPR patients treated with PPIs were weaned at 3-year posttreatment time. Different forms of LPR may exist regarding symptom relief, recurrences, and chronic course.

Chondrolaryngoplasty for transgender patients: feasibility of a scar-free approach

PURPOSE

Adult male-to-female transgender patients with a prominent thyroid notch can benefit from chondrolaryngoplasty with high satisfaction rates. It is a safe, effective, and established procedure with only minor and temporary complications. Until now, only external approaches have been described, leaving the patient with a cervical scar, which remains a frequent complaint. The goal of this study is to assess the feasibility of a transvestibular endoscopic chondrolaryngoplasty.

METHODS

Transvestibular endoscopic chondrolaryngoplasty was conducted on six fresh adult male cadavers. The thyroid cartilage approach was similar to the one described in cases of transvestibular endoscopic thyroidectomy. After thyroid notch exposition, the laryngeal prominence was shaved down using an endoscopic burr until the desired aesthetic result was achieved.

RESULTS

Laryngeal prominence volume was significantly reduced without any cutaneous scar.

CONCLUSION

We have demonstrated that this novel approach is feasible and has the advantage of leaving the patient's neck scar-free.