Reliability of a laryngo-pharyngeal esthesiometer and a method for measuring laryngo-pharyngeal mechano-sensitivity in a prospectively recruited cohort of patients.
There are not reliable methods for measuring laryngo-pharyngeal mechano-sensitivity (LPMS). We aimed to determine the reliability of a new method for measuring LPMS using a new laryngo-pharyngeal esthesiometer (LPEER) in a prospective cohort of dysphagic stroke and non-dysphagic patients. The patients underwent clinical and endoscopic evaluations of swallowing (FESSST). The LPMS assessments consisted of measurements by an expert and a novel rater of the laryngeal-adductor reflex threshold (LART), cough reflex threshold (CRT) and gag reflex threshold (GRT) using the LPEER. We assessed the Bland-Altman limits of agreement, the intraclass correlation coefficients (ICCs) and Spearman correlation coefficients (SCCs). For the inter-rater comparisons, we contrasted the expert and novel raters. A total of 1608 measurements were obtained from 34 dysphagic stroke patients and 33 non-dysphagic patients. The intra-rater ICCs for all reflex thresholds were >0.90. The inter-rater ICCs were 0.87 for the LART, 0.79 for the CRT and 0.70 for the GRT. The intra-rater SCCs for all reflex thresholds were above 0.88 (P < 0.0001). The inter-rater SCC were 0.80 for the LART, 0.79 for the CRT and 0.70 for the GRT (all P < 0.0001). The Bland-Altman plots revealed good agreement for the LART and CRT and moderate agreement for the GRT. The median normal value was 0.14 mN for the LART, 4.4 mN for the CRT and 11.9 mN for the GRT. The median thresholds values in patients with aspiration were LART: 1.31 mN; CRT: 32.9 mN and GRT: 32.9 mN (all P < 0.006 vs normal thresholds). The LPEER exhibited substantial to excellent intra- and inter-rater reliability.
Clinical Formation Unit, School of Medicine, University of Navarra, Irunlarrea 1, 31080, Pamplona, Navarra, Spain. lgiraldo@alumni.unav.es.|Research Department and Clinica Universidad de La Sabana, University of La Sabana School of Medicine, Autonorte de Bogota Km 7, Chia, 25001, Cundinamarca, Colombia. lgiraldo@alumni.unav.es.|Fundacion Neumologica Colombiana, Bogota, DC, Colombia. lgiraldo@alumni.unav.es.
Luis F
http://orcid.org/0000-0002-7574-7913
LF
Giraldo-Cadavid
School of Sciences, University of Navarra, Pamplona, Navarra, Spain.
Javier
J
Burguete
Research Department and Clinica Universidad de La Sabana, University of La Sabana School of Medicine, Autonorte de Bogota Km 7, Chia, 25001, Cundinamarca, Colombia.
Felipe
F
Rueda
Rehabilitation Department, Clinica Universidad de La Sabana, La Sabana University School of Medicine, Chia, Cundinamarca, Colombia.
Ana M
AM
Galvis
Research Department and Clinica Universidad de La Sabana, University of La Sabana School of Medicine, Autonorte de Bogota Km 7, Chia, 25001, Cundinamarca, Colombia.
Natalia
N
Castaneda
University of La Sabana School of Engineering, Chia, Cundinamarca, Colombia.
Luis M
LM
Agudelo-Otalora
University of La Sabana School of Engineering, Chia, Cundinamarca, Colombia.
William D
WD
Moscoso
Fundacion Neumologica Colombiana, Bogota, DC, Colombia.
Nelson
N
Paez
Otorhinolaryngology Department, University Clinic of Navarra, Pamplona, Navarra, Spain.
Secundino
S
Fernandez
D000328:Adult; D003371:Cough / Q000175:diagnosis / Q000503:physiopathology; D003679:Deglutition / Q000502:physiology*; D004724:Endoscopy / Q000379:methods; D005260:Female; D005683:Gagging / Q000502:physiology*; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000503:physiopathology; D007830:Larynx / Q000503:physiopathology; D008297:Male; D010608:Pharyngeal Diseases / Q000175:diagnosis / Q000503:physiopathology; D010614:Pharynx / Q000503:physiopathology; D011446:Prospective Studies; D015203:Reproducibility of Results; D012684:Sensory Thresholds
Bronchoscopy; Endoscopes; Larynx; Reliability; Sensory thresholds