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Predictive Utility of the Penetration‐Aspiration Scale in Inter‐Arytenoid Injection Augmentation
Author(s) -
Weinstock Michael S.,
McCoy Jennifer L.,
Cangilla Kristin,
Shaffer Amber D.,
Maguire Raymond C.,
Tobey Allison B. J.,
Simons Jeffrey P.,
Padia Reema K.
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29142
Subject(s) - medicine , confidence interval , odds ratio , dysphagia , retrospective cohort study , cohort , predictive value of tests , surgery
Objectives/Hypothesis To determine the utility of preoperative penetration‐aspiration scale (PAS) scores and clinical findings on modified barium swallow (MBS) in predicting advancement of diet after interarytenoid injection augmentation (IAIA). Study Design Retrospective review. Methods In this retrospective cohort study, 372 consecutive patients who underwent IAIA for pharyngeal dysphagia between 2009 and 2019 were initially identified. Patients were excluded from the study if they had insufficient preop MBS, no postop MBS within 3 months of injection, supraglottoplasty, or underlying neurological condition. Ninety‐three patients were included in the study. Pre‐ and postoperative PAS scores were recorded, as were pre and postop diets. PAS scores were calculated by a single pediatric speech and language pathologist. Results Average PAS score on MBS was 5.87 (standard deviation [SD] 2.74); median (range) = 8 (1–8). Postop average was 4.29 (SD 3.02); median (range) = 2 (1–8), P < .001. Those with worse preop PAS scores had increased odds of improvement in diet (odds ratio 1.24, 95% confidence interval [CI] 1.02–1.49, P = .029). An improvement in PAS score of 3.0 or greater predicted an improvement in diet with a sensitivity of 76.7% and a specificity of 85.7%. Conclusions PAS score on MBS can be a useful tool when assessing pediatric patients who may be candidates for IAIA. Prospectively comparing PAS score in patients post‐IAIA to patients solely undergoing diet modification can help to better objectively assess differences in outcomes and understand the full utility of PAS score. Level of Evidence Level III (Individual Cohort Study) Laryngoscope , 131:E1707–E1713, 2021