Assessment of Laryngeal Sensory Function using a Tactile Aesthesiometer in Healthy Adults

Ma, Yue; Kidane, Joseph; Gochman, Grant E.; Bracken, David; Strohl, Madeleine P.; Rosen, Clark A.; Young, VyVy N.

doi:10.1002/lary.30540

Cited by 5 publications

(16 citation statements)

References 39 publications

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“…Ma et al investigated laryngeal sensory function using a tactile aesthesiometer in a cohort of 37 healthy adults and showed that for every 10 years of age increment, there was a 19% decrease in the odds of having a laryngeal adductor reflex. In their study, the tactile stimuli were delivered to the false vocal folds, aryepiglottic folds, and lateral pyriform sinus 13 . The negative correlation between smoking and tolerance reported in our study and in the study by Zheng et al is also substantiated by the exaggerated cough and excess of mucus noted in smokers.…”

Section: Discussionsupporting

confidence: 77%

Patient tolerance in office‐based blue laser therapy for lesions of the vocal folds: Correlation with patients' characteristics, disease type and procedure‐related factors

Hamdan

Hosri

Feghali

et al. 2023

Laryngoscope Investig Oto

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ObjectiveTo report patient tolerance in office‐based blue laser therapy for vocal fold lesions.MethodsA retrospective review of the medical records of patients who underwent office‐based blue laser therapy for lesions of the vocal folds between November 2021 and February 2023 was conducted. A total of 48 patients were included. Patient tolerance was assessed using the Iowa Satisfaction with Anesthesia Scale (IOWA). Patient tolerance was analyzed in relation to patients' demographic characteristics, disease type and severity, and procedure‐related factors.ResultsThe mean tolerance score of the study group was 1.51 ± 1.1. There was a significant difference in the mean tolerance score between smokers and non‐smokers (p = .038). Patients with vocal fold cyst (n = 3) had the highest mean tolerance score followed by patients with vocal fold polyps (n = 15). There was a nonsignificant difference in the mean tolerance score between benign lesions of the vocal folds and leukoplakia. Patients with lesions extending to more than half the vocal fold had less tolerance than those with lesions limited to less than half the vocal fold (1.91 vs. 1.27, p value .041). There was a moderate and significant negative correlation between vocal fold movement VAS, swallowing VAS, and tolerance score. The mean total duration of the procedures was 10.38 ± 4.8 min. There was a mild negative correlation between the duration of the procedure and tolerance.ConclusionOffice‐based blue laser therapy for vocal fold lesions is a well‐tolerated procedure. Patient should be instructed how to breathe quietly and avoid swallows to improve tolerance to surgery.Level of Evidence4.

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Section: Discussionsupporting

confidence: 77%

Patient tolerance in office‐based blue laser therapy for lesions of the vocal folds: Correlation with patients' characteristics, disease type and procedure‐related factors

Hamdan

Hosri

Feghali

et al. 2023

Laryngoscope Investig Oto

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“…In a study by Halou et al, incubation of SWMs for at least 6 h in humid and hot environments reduced buckling force. 14 Although this study did not control for humidity and temperature, during sensory evaluation in the clinical setting, each aesthesiometer is used for an average of 11 min and 59 s. 15 These findings suggest that if distortion from salivary entrapment can be resolved and the aesthesiometer can be properly compressed, the delivered buckling force should not significantly change. In vivo clinical testing differs from the ex vivo in that the tissue mucosa will also be coated in saliva.…”

Section: Discussionmentioning

confidence: 91%

“…Tactile Force Measurement 4-0, 5-0, and 6-0 aesthesiometers were constructed, as detailed extensively in previous work, 7,10,15 fixing nylon suture to the end of an open-end ureteral catheter, leaving 30 mm exposed for compression 6 (Figure 2). An intermediate size, 4.5-0, was created using 5-0 nylon suture at a length of 25 mm.…”

Section: Stimulus Delivery Devicementioning

confidence: 99%

An Ex Vivo Investigation of Tactile Aesthesiometer Force in Laryngopharyngeal Sensory Testing

et al. 2022

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Background/Objective Cheung–Bearelly aesthesiometers can deliver buckling‐force stimuli to the laryngopharynx and objectively evaluate sensation. Ambiguity surrounds the transformation of stimuli in the laryngopharyngeal environment. This study aims to evaluate the effect of aesthesiometer size, saliva, successive compressions, and angles of tissue contact on stimulus force delivered. Methods An ex vivo stimulus delivery device was constructed to measure the buckling force of aesthesiometers. Dry and saliva‐saturated aesthesiometers (6–0, 5–0, 4.5–0, and 4–0) were each compressed six times on cadaveric buccal mucosa on an electronic balance. The force for each compression was recorded at 0, 15, 30, 45, and 60° from the vertical plane. 240 compressions were analyzed utilizing a mixed‐effects statistical model. Results The mean force delivered by the 6–0, 5–0, 4.5–0, and 4–0 aesthesiometers were 0.017, 0.082, 0.120, and 0.268 g respectively (p < 0.001). Mean force significantly reduced for the 4–0 aesthesiometer at 30° (p = 0.003) and 60° (p = 0.001). Force decreased by the 4th compression for the 5–0 aesthesiometer (p = 0.004) and after one compression for the 4.5–0 (p = 0.004) and 4–0 (p < 0.001) aesthesiometer. By the 4th compression, the 4.5–0 aesthesiometer was indistinguishable (p > 0.05) from the 5–0 aesthesiometer. The effect of saliva was insignificant (p = 0.83). Conclusion Aesthesiometers can deliver discrete buckling‐force stimuli to evaluate laryngopharynx sensory function. Up to 60° (15° for 4–0 aesthesiometer) deviation from orthogonal tissue contact and salivary forces do not significantly alter force delivered. 4.5–0 aesthesiometers should be exchanged after three compressions. For all other aesthesiometers, force reduction after six compressions is likely clinically insignificant given current laryngopharyngeal sensory testing protocols. Level of Evidence N/A Ex Vivo Laboratory Design Laryngoscope, 133:1933–1937, 2023

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“…Healthy controls were defined as adults between 18 and 85 years of age without laryngopharyngeal disease and were subject to the same screening and exclusion criteria 23 . Additionally, controls were excluded if they had abnormal patient reported outcome measures (i.e., Reflux Symptom Index (RSI) score > 13, Eating Assessment Tool‐10 (EAT‐10) score > 2, or Voice Handicap Index‐10 (VHI‐10) score > 11).…”

Section: Methodsmentioning

confidence: 99%

“…The 6–0, 5–0, and 4–0 monofilaments deliver an increasing mean force of 0.03, 0.11, and 0.30 g respectively 12 . An intermediary strength “4.5–0” monofilament was created by using a 5–0 monofilament of 25 mm length, which has been demonstrated to have a mean buckling force of 0.19 g 23 …”

Section: Methodsmentioning

confidence: 99%

Abnormal Laryngopharyngeal Sensation in Adductor Laryngeal Dystonia Compared to Healthy Controls

et al. 2022

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Background/ObjectivesLaryngeal sensory abnormality has been implicated as a component of adductor laryngeal dystonia (AdLD). The study objective was to assess laryngopharyngeal sensation in AdLD utilizing a calibrated, tactile aesthesiometer to deliver differential stimuli to lateral pyriform sinus (LPS), aryepiglottic fold (AEF), and false vocal fold (FVF).MethodsPatients with known Botox‐responsive AdLD underwent sensory testing using a previously‐validated methodology involving calibrated tactile stimuli (6–0, 5–0, 4.5–0, 4–0 nylon monofilaments). Laryngeal adductor reflex (LAR) and participant‐rated perceptual strength of stimulI were evaluated. Responses were compared to normative controls (n = 33). Two‐samples, Mann–Whitney and Fisher exact tests compared mean strength ratings and LAR between AdLD and control groups. Mixed‐effects logistic regression and linear models assessed association of filament size, stimulus site, age, sex, and LD status on LAR and perceptual strength rating respectively.ResultsThirteen AdLD patients (nine women, mean age 60+/−15 years) completed testing. Average LAR response rates were higher amongst all filament sizes in AdLD versus controls at LPS (56.3% vs. 35.7%) and AEF (96.1% vs. 70.2%) with comparable rates at FVF (90.2% vs. 91.7%). AdLD had 3.3 times the odds of observed LAR compared to controls (p = 0.005), but differences in subjective detection of stimuli, perceptual strength ratings, and cough/gag rates were insignificant on multivariate modeling (p > 0.05).ConclusionsThis is the first study to objectively assess laryngopharyngeal sensation in AdLD. Findings demonstrated increased laryngopharyngeal sensation in AdLD compared to controls. The identification of increased laryngeal hypersensitivity in these patients may improve understanding of AdLD pathophysiology and identify future targets for intervention.Level of Evidence2 Laryngoscope, 133:2271–2278, 2023

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Assessment of Laryngeal Sensory Function using a Tactile Aesthesiometer in Healthy Adults

Cited by 5 publications

References 39 publications

Patient tolerance in office‐based blue laser therapy for lesions of the vocal folds: Correlation with patients' characteristics, disease type and procedure‐related factors

Patient tolerance in office‐based blue laser therapy for lesions of the vocal folds: Correlation with patients' characteristics, disease type and procedure‐related factors

An Ex Vivo Investigation of Tactile Aesthesiometer Force in Laryngopharyngeal Sensory Testing

Abnormal Laryngopharyngeal Sensation in Adductor Laryngeal Dystonia Compared to Healthy Controls

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