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.

Comparing the potential of MEG and EEG to uncover brain tracking of speech temporal envelope.

During connected speech listening, brain activity tracks speech rhythmicity at delta (∼0.5 Hz) and theta (4-8 Hz) frequencies. Here, we compared the potential of magnetoencephalography (MEG) and high-density electroencephalography (EEG) to uncover such speech brain tracking. Ten healthy right-handed adults listened to two different 5-min audio recordings, either without noise or mixed with a cocktail-party noise of equal loudness. Their brain activity was simultaneously recorded with MEG and EEG. We quantified speech brain tracking channel-by-channel using coherence, and with all channels at once by speech temporal envelope reconstruction accuracy. In both conditions, speech brain tracking was significant at delta and theta frequencies and peaked in the temporal regions with both modalities (MEG and EEG). However, in the absence of noise, speech brain tracking estimated from MEG data was significantly higher than that obtained from EEG. Furthemore, to uncover significant speech brain tracking, recordings needed to be ∼3 times longer in EEG than MEG, depending on the frequency considered (delta or theta) and the estimation method. In the presence of noise, both EEG and MEG recordings replicated the previous finding that speech brain tracking at delta frequencies is stronger with attended speech (i.e., the sound subjects are attending to) than with the global sound (i.e., the attended speech and the noise combined). Other previously reported MEG findings were replicated based on MEG but not EEG recordings: 1) speech brain tracking at theta frequencies is stronger with attended speech than with the global sound, 2) speech brain tracking at delta frequencies is stronger in noiseless than noisy conditions, and 3) when noise is added, speech brain tracking at delta frequencies dampens less in the left hemisphere than in the right hemisphere. Finally, sources of speech brain tracking reconstructed from EEG data were systematically deeper and more posterior than those derived from MEG. The present study demonstrates that speech brain tracking is better seen with MEG than EEG. Quantitatively, EEG recordings need to be ∼3 times longer than MEG recordings to uncover significant speech brain tracking. As a consequence, MEG appears more suited than EEG to pinpoint subtle effects related to speech brain tracking in a given recording time.