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

OBJECTIVE

We aim to determine the frequency of altered swallowing physiology for ratable components of the 17-component grading system, the Modified Barium Swallow Impairment Profile (MBSImp), in its current validated state for a cohort of patients post total laryngectomy (TL).

STUDY DESIGN

Retrospective study.

SETTING

Otolaryngology Head & Neck Surgery, The George Washington University Hospital and George Washington University Medical Faculty Associates.

METHODS

All participants received a VFSS as part of standard care, which was scored post hoc using the MBSImP protocol and scoring metric by two blinded speech-language pathologists.

RESULTS

Due to anatomical changes post-TL, Components 6, 8, 9, 10, and 11 of the MBSImP were not rated. Efficiency concerns were most prevalent with functional deficits noted for: pharyngeal stripping wave, pharyngoesophageal segment opening, tongue base retraction, pharyngeal residue, and esophageal clearance.

CONCLUSIONS

Our work aims to provide further insight into the swallowing characteristics of TL as measured using the MBSImP. A high frequency of biomechanical impairment was identified in this cohort of patients. Although the MBSImP is a validated tool its application to the reconstructed anatomy following TL is not precise and should be regarded with caution in clinical settings. Further work is needed to modify definitions of the MBSImP components and inclusion of additional features that can more accurately describe post-TL dysphagia.