Assessment of vocal fold movement through anterior–posterior view of videofluoroscopic swallowing study

OBJECTIVE: The aim of this study is to assess the value of using videofluoroscopic swallowing study (VFSS) for assessing vocal fold paralysis. METHODS: This was a retrospective study of patients who underwent VFSS with a vocal fold testing maneuver from June 2020 to February 2022, and who had undergone laryngoscopy within 2 weeks before or after VFSS. The vocal fold testing maneuver consisted of making an ‘e’ sound for about 2–3 seconds during VFSS anterior–posterior (AP) view. The diagnostic value of the VFSS was evaluated by a trained reviewer, who assessed the presence and laterality of vocal fold paralysis by examining videos of the patients performing the vocal fold testing maneuver. Intra‐rater reliability was determined by evaluation of the videos by the same reviewer 2 weeks later, and inter‐rater reliability was determined by evaluation by a second reviewer. RESULTS: Seventy patients were enrolled in the study. The positive predictive value was 91.43% and the intra‐rater and inter‐rater reliabilities, as determined by Cohen's kappa value, were 0.746 and 0.824 respectively. CONCLUSIONS: The presence and laterality of vocal fold paralysis were identified accurately and reliably by the reviewers, showing that VFSS can be used to assess vocal fold paralysis. LEVEL OF EVIDENCE: 2.