The risk categories in the guidelines are valid to assist early identification of swallowing and nutritional risk and guide decision-making on proactive gastrostomy tube insertion.

Ten laryngectomy patients were assessed using a purpose-designed, multimedia videoconferencing system incorporating a freestanding, self-focusing camera. Swallowing, stoma and communication status were assessed simultaneously by a remote clinician and face-to-face, by a second clinician at the patient's site. The remote trial took place over a distance of approximately 1700 km using a commercial 3G phone network. A satisfaction questionnaire was also completed. There was excellent agreement between the two assessing clinicians. Image quality obtained via the freestanding camera was rated as lower than direct observation, but it was sufficient to assess the stoma and status of the voice prosthesis. During the trial, occasional difficulties with audio delays and image distortion were experienced, although these were manageable. Both patient and clinician satisfaction with remote assessment was high. The results provide further evidence to support the use of telerehabilitation for evaluating the speech and swallowing status of laryngectomy patients following discharge from acute care.

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Minor modifications to the high risk definition in the guidelines have improved the guideline sensitivity for future use. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1163-E1171, 2016.

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