Correlation between the Murray Secretion Scale and the Yale Pharyngeal Residue Severity Rating Scale

Resumen

Introduction: The Murray Secretion Scale (MSS) is a validated instrument for the assessment of the accumulation of secretions and can be used during any fiberoptic nasopharyngoscopy (FNP) by the general otorhinolaryngologist. The Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) was developed for the determination of pharyngeal residue after swallowing and is used during the formal swallowing assessment consultation.

Objectives: To compare the correlation between MSS and YPRSRS both in ENT professionals with and without experience in deglutition evaluation.

Material and Methods: 40 flexible endoscopic evaluation of swallowing (FEES) were selected from a retrospective cohort. The evaluation was carried out by 8 different clinicians, 2 of them experienced in deglutition. All exams were graded according to the degree of severity using the two scales.

Results: There was a strong correlation between the assessments of each observer on both scales (Τβ between 0.327 p=0.014 and 0.598 p=0.001). The inter-observer correlation was higher the more experienced the judges were: κ=0.369 (95% CI, 0.366 to 0.373), p=0,001 vs κ=0832(95% CI 0.827 to 0.838), p=0,001 for MSS and κ=0.305 (95% CI, 0.302 to 0.308), p=0,001 vs κ=0.678 (95% CI,0.673 to 0.684) p=0,001 for YPRSRS.

Conclusion: There was a significant correlation between the classification on the MSS and the YPRSRS in observers with and without experience. Presence of salivary stasis in the FNP may alert the general ENT to the potential risk of pharyngeal residue after swallowing and to the need to referral to a swallowing assessment.