Laryngopharyngeal sensory discrimination testing and the laryngeal adductor reflex

John H. Martin, Jeanne E. Thomson, Jonathan E. Aviv, Ted Kim, Beverly Diamond, Ralph L Sacco, Lanny G. Close

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Laryngopharyngeal sensory capacity has been determined by endoscopically administering air pulse stimuli to the mucosa innervated by the superior laryngeal nerve and asking the patient if he or she feels the stimulus. A potential shortcoming of this psychophysical testing (PT) procedure is that it is a subjective test, and patients with impaired cognition may not be able to perform the required task. In the search for an objective measure of laryngeal sensory function, we have observed that the laryngeal adductor reflex (LAR) is evoked at stimulus intensities similar to those capable of eliciting the psychophysical, or perceptual, response. The purpose of this study is to determine if the threshold for eliciting the LAR is the same as that of the sensory threshold. A specially designed endoscope was used to present air pulse stimuli (range 0.0 to 10 mm Hg) to the laryngopharynx in 20 healthy subjects and in 80 patients with dysphagia, using both PT and the LAR. The patients had a variety of underlying diagnoses, with stroke and chronic neurologic disease predominating (n = 65). In the control group and in the group of patients with dysphagia, there was no statistically significant difference between the median laryngopharyngeal sensory thresholds whether we used PT or the LAR (p > .05, Wilcoxon signed-rank test). The intraclass correlation for the total sample was .999 (U = .999, L = .998). Since psychophysical and sensorimotor reflex thresholds were not statistically significantly different and the intraclass correlation was close to a perfect correlation, we conclude that the LAR can be used as an objective and accurate clinical method of endoscopically assessing laryngopharyngeal sensory capacity.

Original languageEnglish
Pages (from-to)725-730
Number of pages6
JournalAnnals of Otology, Rhinology and Laryngology
Volume108
Issue number8
StatePublished - Aug 17 1999
Externally publishedYes

Fingerprint

Reflex
Sensory Thresholds
Deglutition Disorders
Air
Laryngeal Nerves
Hypopharynx
Endoscopes
Nonparametric Statistics
Nervous System Diseases
Cognition
Discrimination (Psychology)
Healthy Volunteers
Mucous Membrane
Chronic Disease
Stroke
Control Groups

Keywords

  • Dysphagia
  • Endoscopy
  • Laryngopharyngeal sensation
  • Swallowing

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Martin, J. H., Thomson, J. E., Aviv, J. E., Kim, T., Diamond, B., Sacco, R. L., & Close, L. G. (1999). Laryngopharyngeal sensory discrimination testing and the laryngeal adductor reflex. Annals of Otology, Rhinology and Laryngology, 108(8), 725-730.

Laryngopharyngeal sensory discrimination testing and the laryngeal adductor reflex. / Martin, John H.; Thomson, Jeanne E.; Aviv, Jonathan E.; Kim, Ted; Diamond, Beverly; Sacco, Ralph L; Close, Lanny G.

In: Annals of Otology, Rhinology and Laryngology, Vol. 108, No. 8, 17.08.1999, p. 725-730.

Research output: Contribution to journalArticle

Martin, JH, Thomson, JE, Aviv, JE, Kim, T, Diamond, B, Sacco, RL & Close, LG 1999, 'Laryngopharyngeal sensory discrimination testing and the laryngeal adductor reflex', Annals of Otology, Rhinology and Laryngology, vol. 108, no. 8, pp. 725-730.
Martin, John H. ; Thomson, Jeanne E. ; Aviv, Jonathan E. ; Kim, Ted ; Diamond, Beverly ; Sacco, Ralph L ; Close, Lanny G. / Laryngopharyngeal sensory discrimination testing and the laryngeal adductor reflex. In: Annals of Otology, Rhinology and Laryngology. 1999 ; Vol. 108, No. 8. pp. 725-730.
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