Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

Abstract

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

Relação do tempo de trânsito faríngeo e presença de resíduo com dispneia e função pulmonar na doença pulmonar obstrutiva crônica

“…Pacientes com estas características clínicas se enquadram para o tratamento farmacológico nos grupos B ou D conforme o esquema ABCD proposto no GOLD (14) . Apesar de não estar clara a relação, estudos tem apontado para a medicação inalatória utilizada no tratamento da DPOC como possível causa de alteração sensorial detectada em cavidade oral e laringofaríngea de indivíduos com DPOC (29)(30) . O prejuízo sensorial em laringofaringe poderia justificar a presença de resíduo faríngeo nestes indivíduos.…”

Quantitative Videofluoroscopic Analysis of Swallowing Physiology and Function in Individuals With Chronic Obstructive Pulmonary Disease

“…However, impairments in laryngeal sensation have been reported in the COPD population ( Clayton et al, 2014 ), with one possible contributing factor being the high use of inhaled corticosteroid medications in this population. Whether sensory deficits also exist in the oropharynx and manifest in the form of long swallow reaction times remains less clear ( Borowsky da Rosa et al, 2020 ). Interestingly, the current study actually found higher rates of prolonged swallow reaction times on moderately and extremely thick liquids in the healthy reference sample.…”

Distinctive features of the oropharyngeal microbiome in Inuit of Nunavik and correlations of mild to moderate bronchial obstruction with dysbiosis

“…To offset this gap in knowledge, a broad health survey that included a comprehensive respiratory health analysis of the Inuit aged 16 and over was recently conducted in Nunavik 6 . In addition to a detailed questionnaire, this survey was further enhanced by oropharyngeal (OP) swabs, as well as spirometry measurements, a lung function test detecting airway obstruction 7 – 9 . While close to 60% of Nunavimmiut reported one of the symptoms of respiratory health (chronic cough, chronic sputum, wheezing), the vast majority had no airway obstruction as determined by spirometry with 9% showing mild obstruction (GOLD 1) and 5% a moderate obstruction (GOLD 2) 6 .…”