Laryngeal sensitivity evaluation and dysphagia: Hospital Sírio-Libanês experience.
BACKGROUND
Laryngeal sensitivity is important in the coordination of swallowing coordination and avoidance of aspiration.


OBJECTIVE
To briefly review the physiology of swallowing and report on our experience with laryngeal sensitivity evaluation among patients presenting dysphagia.


METHODS
Prospective.


METHODS
Endoscopy Department, Hospital Sírio-Libanês.


METHODS
Clinical data, endoscopic findings from the larynx and the laryngeal sensitivity, as assessed via the Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST) protocol (using the Pentax AP4000 system), were prospectively studied. The chi-squared and Student t tests were used to compare differences, which were considered significant if p < or = 0.05.


RESULTS
The study included 111 patients. A direct association was observed for hyperplasia and hyperemia of the posterior commissure region in relation to globus (p = 0.01) and regurgitation (p = 0.04). Hyperemia of the posterior commissure region had a direct association with sialorrhea (p = 0.03) and an inverse association with xerostomia (p = 0.03). There was a direct association between severe laryngeal sensitivity deficit and previous radiotherapy of the head and neck (p = 0.001).


CONCLUSIONS
These data emphasize the association between proximal gastroesophageal reflux and chronic posterior laryngitis, and suggest that decreased laryngeal sensitivity could be a side effect of radiotherapy.


CONCLUSIONS
Even considering that these results are preliminary, the endoscopic findings from laryngoscopy seem to be important in the diagnosis of proximal gastroesophageal reflux. Study of laryngeal sensitivity may have the potential for improving the knowledge and clinical management of dysphagia.
Parise Junior
Orlando
O
Hospital Sírio-Libanês, São Paulo, Brazil. oparise@uol.com.br
Miguel
Roberto Elias Villela
RE
Gomes
Daniela Luci D'Aquino
DL
Menon
Antonio Douglas
AD
Hashiba
Kiyoshi
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005336:Fiber Optic Technology; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012678:Sensation Disorders / Q000175:diagnosis / Q000503:physiopathology*