Union of the European Phoniatricians' position statement on the exit strategy of phoniatric and laryngological services : staying safe and getting back to normal after the peak of coronavirus disease 2019 (issued on 25th May 2020)

Background The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. Objectives This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. Conclusion As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.Peer reviewe

Risk factors associated with aspiration after partial laryngectomies

En Abstract Hypothesis Aspiration and dysphagia still remain the most common drawbacks limiting conservation partial laryngeal surgery. Videofluoroscopic swallowing study (VFSS) has became the gold standard examination that guides the surgeon about important risk factors, helping him in technique selection and anatomical structure preservation, in balance with radical removal of laryngeal neoplasms. Objectives The purpose of this study was to determine the major risk factors for postoperative aspiration using VFSS and how to overcome it following different types of partial laryngectomies. Study design The authors conducted a prospective evaluation comparative study. Patients and methods This study was conducted on patients with laryngeal carcinoma who underwent partial laryngectomy between October 2009 and May 2012. VFSS was carried out to evaluate postoperative swallowing and aspiration. Statistical analyses were performed using Pearson’s χ2 and Spearman’s rank correlation test to detect the major risk factors associated with aspiration. Results Thirty-two patients were enrolled in the present study. Six different types of partial laryngeal surgeries were carried out according to the size and extent of the primary tumor. Twenty-five (78.12%) patients suffered from various degrees of aspiration. Age, smoking, site of tumor, resection of valleculae, epiglottis, hyoid bone, ventricular folds, and true vocal folds were significantly associated with aspiration (P<0.05). Conclusion Aspiration is common after partial laryngeal surgeries but is rarely severe or permanent. VFSS should be used before and after any partial laryngectomy to exclude silent aspiration and the risk for aspiration pneumonia. Aspiration can be minimized with careful patient selection and precise surgical technique selection and perfection