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.

Psychophysical evaluation of chemosensory functions 5 weeks after olfactory loss due to COVID-19: a prospective cohort study on 72 patients.

PURPOSE: To evaluate the evolution of chemosensation via extended psychophysical testing in patients who suffered from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19). Additionally, this study sought to determine whether odor threshold testing provided additional information on olfactory loss due to COVID-19 compared to the more common odor identification testing. METHODS: Prospective cohort study of patients with sudden chemosensory loss since February 2020 and confirmed COVID-19 infection via RT-PCR or serology testing. Olfactory function was tested extensively using the "Sniffin Sticks" test battery. In addition, we screened gustatory perception and nasal cooling sensations using psychophysical tests. RESULTS: Seventy-two patients completed the study. After a mean of 37 days, 37% of patients showed olfactory dysfunction, 7% were dysgeusic, and 48% showed signs of low sensitivity for cooling sensation. A longer duration of anosmia before smell improvement was correlated with lower olfactory function at 5 weeks. Odor threshold detection was more affected by COVID-19 compared to odor identification. CONCLUSION: Five weeks after developing sudden chemosensory loss due to COVID-19, a high proportion of patients were dysosmic and showed signs of low nasal cooling sensitivity, whereas most of them had normal taste function. SARS-CoV-2 affected mainly odor thresholds, possibly suggesting that the major cause of loss of smell lies at the level of the olfactory neuroepithelium, rather than in the central nervous system.

Validity and reliability of a French version of M.D. Anderson Dysphagia Inventory.

OBJECTIVE: To assess the internal consistency, reliability, and clinical validity of a French version of the M.D. Anderson Dysphagia Inventory (Fr-MDADI). METHODS: Patients addressed in the Swallowing Clinics of CHU Saint-Pierre Hospital (Brussels) and EpiCURA hospital (Ath, Belgium) for dysphagia completed Fr-MDADI, eating assessment tool-10 (EAT-10), dysphagia handicap index (DHI), and benefited from fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy. Seventy-two asymptomatic individuals composed the control group. The reliability of Fr-MDADI was assessed through a test-retest procedure. The validity was assessed by comparing Fr-MDADI with EAT-10 scores. Normative value of Fr-MDADI was calculated through the receiver operating characteristic (ROC) curve. RESULTS: Forty-two patients and 77 healthy individuals completed the evaluations (33 males). The main etiology of dysphagia was head and neck cancers. The internal consistency was high regarding the Cronbach's alpha (0.864). The test-retest reliability was high for Fr-MDADI total scores (rs = 0.849). The Fr-MDADI emotional, functional and physical subscores, and the total score exhibited high positive correlations with EAT-10 (rs = 0.770) and DHI (rs = 0.811), exhibiting high external validity. Patients had significant higher item and total score of Fr-MDADI compared with healthy individuals (control group), which indicated an adequate internal validity. About normative data, a Fr-MDADI > 13 was considered to be reflective of abnormalities. The 'swallowing-induced cough' item of the Fr-MDADI was significantly associated with the occurrence of aspirations regarding objective examinations (FEES or videofluoroscopy; p = 0.001). CONCLUSION: The Fr-MDADI is a reliable and valid self-administered tool in the evaluation of the dysphagia of French-speaking patients.

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.

Validity and reliability of the French version of Eating Assessment Tool (EAT-10).

OBJECTIVE: To develop a French version of the Eating Assessment Tool (Fr EAT-10) and to assess its internal consistency, reliability and clinical validity. METHODS: Fifty-six patients referred in the Swallowing Clinics of CHU Saint-Pierre Hospital (Brussels) and EpiCURA hospital (Ath, Belgium) for dysphagia were enrolled and completed fiberoptic endoscopic evaluation of swallowing and videofluoroscopy. Seventy-three asymptomatic subjects were included in the study. To assess reliability, Fr-EAT-10 was completed twice within a 7-day period. Validity was assessed by comparing Fr-EAT-10 scores with the scores of dysphagia handicap index (DHI) in all individuals. Normative value of EAT-10 was calculated and the receiver operating characteristic (ROC) curve was used to determine the best Fr-EAT-10 threshold associated with aspiration. RESULTS: Fifty-two patients completed the study. Cronbach's alpha was 0.95 indicating a high internal consistency. Test-retest reliability was high in the entire cohort (rs = 0.921). The correlation between Fr-EAT-10 total scores and DHI was high (rs = 0.827) indicating a high external validity. Patients had a significant higher score of Fr-EAT-10 than the controls (p < 0.001) exhibiting a high internal validity. The analysis of normative data reported that a score of Fr-EAT-10 > 3 should be considered as abnormal. The correlation between Fr-EAT-10 and the occurrence of aspiration is significant (rs = 0.327, p < 0.05). According to the ROC curve; aspirations need to be highly suspected for patients with Fr-EAT-10 ≥ 17. CONCLUSION: The Fr-EAT-10 developed in this study is a reliable and valid self-administered tool in the evaluation of dysphagia in French-speaking patients.