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Introduction: Previous studies estimating the reliability of the Penetration-Aspiration Scale (PAS) for scoring flexible endoscopic evaluation of swallowing (FEES®) have not considered prior experience in the procedure as an influencing factor. The current study aimed to compare the PAS scores assigned to a set of random, blinded endoscopic swallow studies across entirely novel and experienced FEES® clinicians. Methods: Expert clinicians independently rated a set of FEES® swallows, and novel clinicians did the same after a quick orientation and demonstration on components of PAS. The scores agreed upon by the expert clinicians were considered as a target score for each swallow against which the scores assigned by novel clinicians were compared. Results: Results revealed a significant difference in PAS scores across the two groups for all swallows except the first, postorientation (P < 0.05) probably indicating an immediate training effect that was not maintained. Analysis on learning pattern among the novel clinicians revealed no specific trend but suggested that the clinicians could identify normal and abnormal airway protection in majority of the trials, but had difficulty assigning the correct PAS scores. The penetration to the level of the glottis was most often incorrectly scored. Conclusion: The current study warns the clinicians about reliability of PAS scores communicated as a factor of clinical experience of the examiner who conducted the study. These results imply the need for task-specific training when it comes to implementation of tools in clinical science. Such training may help improve uniform practice and professional communication of patient-related data more reliable. [ABSTRACT FROM AUTHOR]

Introduction: Sulcus vocalis is a condition of true vocal folds presenting as a linear furrow on the mucosal lining, lengthening toward the entire vibratory surface. Differential diagnosis between physiologic and pathologic sulcus vocalis has traditionally been based upon videostroboscopy that does not conclusively differentiate between the two. Hence, the present study was intended to utilize the electroglottograph (EGG), a routinely utilized voice evaluation tool to track morphological vibratory patterns in these conditions aiding in differential diagnosis. Method: A total of 40 individuals diagnosed as physiologic (17) and pathologic sulcus (23) based on stroboscopic examinations and history details were recruited as the participants for the study and were made to undergo the EGG procedure. Results: The majority of the participants with physiologic sulcus, obtained normal wave morphology barring four participants who demonstrated deviant patterns. In cases of pathologic sulcus, varied wave patterns obtained were prolonged open phase, pit such as undulation in closed phase, abrupt closing phase, and reduced amplitude waveform. Conclusions: The current study enhances the utility of EGG in cases of sulcus and its types (physiologic and pathologic sulcus) by revealing distinct waveform patterns in each and thereby aiding differential diagnosis too. These results from EGG are much relevant to voice clinicians especially in conditions where other evaluation tools are restricted. [ABSTRACT FROM AUTHOR]

The present study was intended to examine the stroboscopic parameters with regard to the extent and type of deviancies or variations from normalcy in perceptually phononormic individuals. Fifty perceptually phononormic individuals who served as the participants for the study were made to undergo Videostroboscopic examinations by an experienced Otolaryngologist. Later, all the recordings were examined, and under glottal activity majority of the parameters inclined towards normalcy but for certain deviations noticed for glottis closure and amplitude. Under supraglottal activity variations were noticed mainly under the structure and functioning of epiglottis, ventricular folds and arytenoids. These findings of the current study advocate that the presence of slight anatomically deviant parameters (probable normal variations) alone without any related presenting complaints do not serve as diagnostic hallmarks, mainly in cases of Functional or Non organic dysphonia and serves to caution in exercising just the theoretical framework in diagnosis of primarily functional dysphonia. [ABSTRACT FROM AUTHOR]