Utilizing Modified Barium Swallow Impairment Profile (MBSImP) to Characterize Swallowing Function Following Total...

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Swallowing Disorders

Background:

• Total laryngectomy (TL) significantly alters head and neck anatomy.
• Swallowing dysfunction is a common sequela following TL.
• The Modified Barium Swallow Impairment Profile (MBSImp) is a validated tool for assessing swallowing physiology.

Purpose of the Study:

• To determine the frequency of altered swallowing physiology using the MBSImp in patients post-TL.
• To evaluate the applicability of the current MBSImp components to the unique anatomy after TL.
• To identify specific swallowing impairments prevalent in the TL population.

Main Methods:

• Retrospective study design.
• Analysis of videofluoroscopic swallow studies (VFSS) from patients post-TL.
• Post hoc scoring of VFSS using the MBSImP protocol by blinded speech-language pathologists.

Main Results:

• Several MBSImp components (6, 8, 9, 10, 11) were not ratable due to anatomical changes post-TL.
• Prevalent functional deficits included impaired pharyngeal stripping wave, pharyngoesophageal segment opening, tongue base retraction, pharyngeal residue, and esophageal clearance.
• Efficiency concerns were most notable in these impaired areas.

Conclusions:

• A high frequency of biomechanical swallowing impairments exists in patients post-TL.
• The MBSImp, while validated, requires cautious application and potential modification for post-TL reconstructed anatomy.
• Further research is needed to refine MBSImp components for accurate assessment of post-TL dysphagia.