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Aesthesiometer-Based Testing for Laryngopharyngeal Hyposensitivity.

Madeleine P Strohl1, Abel P David1, Christopher D Dwyer1

  • 1Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A.

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Summary
This summary is machine-generated.

This study developed a method to estimate the laryngeal adductor reflex (LAR) threshold using monofilaments. A decision tree protocol can identify patients at risk for laryngopharyngeal hyposensitivity.

Keywords:
Aesthesiometerdichotomous classifier performancelaryngeal adductor reflexnylon monofilamentsthreshold estimation

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Area of Science:

  • Otolaryngology
  • Neuroscience
  • Physiology

Background:

  • The laryngeal adductor reflex (LAR) is crucial for airway protection.
  • Accurate estimation of the LAR triggering threshold is important for diagnosing swallowing and voice disorders.
  • Current methods for LAR threshold estimation can be burdensome and lack standardization.

Purpose of the Study:

  • To develop and validate a standardized method for estimating the LAR response threshold using Cheung-Bearelly monofilaments.
  • To formulate a test protocol that minimizes patient burden while accurately determining the LAR triggering threshold.

Main Methods:

  • A cross-sectional study involving 22 healthy adults.
  • Tactile stimuli were applied to the aryepiglottic (AE) fold and medial pyriform sinus (MPS) using 5-0 and 4-0 nylon monofilaments.
  • Classifier performance, agreement, and test-retest reliability were analyzed to formulate a decision tree protocol.

Main Results:

  • The 4-0 monofilament demonstrated higher classifier performance (AUC) compared to the 5-0 monofilament for both AE fold and MPS stimulation.
  • Agreement for positive LAR response was high (93%), but low for negative responses (29%).
  • Test-retest reliability for LAR response outcome was excellent (Cronbach's alpha = 0.97).

Conclusions:

  • A decision tree protocol using monofilament stimulation can operationalize LAR threshold estimation.
  • Positive LAR response is expected in over 90% of asymptomatic adults.
  • Negative LAR response to 4-0 monofilament stimulation may indicate a risk for laryngopharyngeal hyposensitivity.