Dil Konuşma ve Yutma Araştırmaları Dergisi
Yazarlar: Serkan BENGİSU, İlayda GÜNDÜZ
Konular:-
Anahtar Kelimeler:Dysphagia,Swallowing disorder,Vocal cord paralysis,Aspiration,Penetration
Özet: Purpose: The purpose of this study was to evaluate the presence of aspiration-penetration in patients with unilateral vocal cord paralysis, and to examine the correlation between the findings of the Gugging Swallowing Screen (GUSS), which is a subjective evaluation method, and the Fiberoptic Endoscopic Swallowing Study (FEES), which is objective. Method: Correlational research model was used in this study. 8 patients with unilateral vocal cord paralysis who were seen at the ear nose throat clinic of İstanbul Samatya Education Research Hospital within a 6-month period in 2018 and the beginning of 2019 were included in this study. 4 of the 8 patients (50%) were female and 4 (50%) were male. In 4 patients (%50), the paralysis was seen in the right vocal cord and in the other 4 patients (%50), in the left vocal cord. The cause of paralysis in 4 of 8 patients (%50) was thyroidectomy, in 3 (%37,5), it was idiopathic and in 1 (%12,5) patient, it was seen following pneumonectomy. After filling out an information form with the medical history and complaints of the patients, GUSS was administered by a speech and language therapist and FEES was implemented by an ear nose throat doctor. Results: 6 (75%) of the 8 patients were diagnosed with the presence of aspiration-penetration using GUSS, and 4 (%50) were diagnosed to have aspiration-penetration using FEES. There was no relationship between the FEES and the GUSS scores (r=-0.247; p=0.555). Conclusion: In patients with unilateral VCP, as a result of the vocal cords being immobilized due to paralysis, airway protection may deteriorate. The GUSS and FEES assessments performed in this study showed that a large majority of patients with VCP demonstrated signs of aspiration and/or penetration. Assessment with GUSS resulted in identifying more cases as having aspiration- penetration than FEES. 4 of 6 patients who were diagnosed to have aspiration-penetration with the GUSS evaluation were also found to have aspiration-penetration following objective evaluation, FEES. The other two were possibly false positives. False positives are likely to urge patients and therapists to be more cautious in therapy. Therefore, it can be concluded that GUSS can be used as an alternative measurement tool in clinical conditions and can give an idea of aspiration presence in patients with unilateral VCP, in cases where an objective assessment of aspiration is not possible. These results are in line with the literature findings. For further confirmation, it is recommended that the study be repeated with a larger number of patients.