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Advancing Laryngeal Adductor Reflex Testing Beyond Sensory Threshold Detection.
Lever, Teresa E; Kloepper, Ashley M; Deninger, Ian; Hamad, Ali; Hopewell, Bridget L; Ovaitt, Alyssa K; Szewczyk, Marlena; Bunyak, Filiz; Zitsch, Bradford; Blake, Brett; Vandell, Caitlin; Dooley, Laura.
Afiliação
  • Lever TE; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA. levert@health.missouri.edu.
  • Kloepper AM; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.
  • Deninger I; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.
  • Hamad A; Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, USA.
  • Hopewell BL; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.
  • Ovaitt AK; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.
  • Szewczyk M; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.
  • Bunyak F; Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, USA.
  • Zitsch B; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.
  • Blake B; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.
  • Vandell C; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.
  • Dooley L; Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.
Dysphagia ; 37(5): 1151-1171, 2022 10.
Article em En | MEDLINE | ID: mdl-34686917
ABSTRACT
Flexible endoscopic evaluation of swallowing with sensory testing (FEESST) is a promising clinical tool to assess airway integrity via the laryngeal adductor reflex (LAR). The current clinical protocol relies on sensory threshold detection, as relatively little is known about the motor response of this sensorimotor airway protective reflex. Here, we focused on characterizing normative LAR motion dynamics in 20 healthy young participants using our prototype high-pressure syringe-based air pulse device and analytic software (VFtrack™) that tracks vocal fold (VF) motion in endoscopic videos. Following device bench testing for air pulse stimulus characterization, we evoked and objectively quantified LAR motion dynamics in response to two suprathreshold air pulse stimuli (40 versus 60 mm Hg), delivered to the arytenoid mucosa through a bronchoscope working channel. The higher air pressures generated by our device permitted an approximate 1 cm endoscope working distance for continual visualization of the bilateral VFs throughout the LAR. Post hoc video analysis identified two main

findings:

(1) there are variant and invariant subcomponents of the LAR motor response, and (2) only a fraction of suprathreshold stimuli evoked complete glottic closure during the LAR. While the clinical relevance of these findings remains to be determined, we have nonetheless demonstrated untapped potential in the current FEESST protocol. Our ongoing efforts may reveal LAR biomarkers to quantify the severity of laryngeal pathology and change over time with natural disease progression, spontaneous recovery, or in response to intervention. The ultimate goal is to facilitate predictive modeling of patients at high risk for dysphagia-related aspiration pneumonia.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transtornos de Deglutição / Laringe Tipo de estudo: Diagnostic_studies / Guideline / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transtornos de Deglutição / Laringe Tipo de estudo: Diagnostic_studies / Guideline / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article