Pediatric Laryngopharyngeal Sensory Testing during Flexible Endoscopic Evaluation of Swallowing: Feasible and Correlative
- 1 October 2000
- journal article
- research article
- Published by SAGE Publications in Annals of Otology, Rhinology & Laryngology
- Vol. 109 (10) , 899-905
- https://doi.org/10.1177/000348940010901002
Abstract
Laryngopharyngeal sensory testing can predict aspiration risk in adult patients. Its feasibility and potential role in the evaluation of pediatric swallowing is undetermined. The goals of this study were to determine the feasibility of performing laryngopharyngeal sensory testing in awake pediatric patients and to assess whether the sensory testing results correlated with aspiration during a feeding assessment or correlated with a history of pneumonia. Fiberoptic endoscopic evaluation of swallowing with sensory testing was performed in 100 pediatric patients who were evaluated for feeding and swallowing disorders. The swallowing function parameters evaluated were pooled secretions, laryngeal penetration, and aspiration. The laryngopharyngeal sensory tests were performed by delivering a pressure-controlled and duration-controlled air pulse to the aryepiglottic fold through a flexible laryngoscope to induce the laryngeal adductor response (LAR). The air pulse stimulus ranged in intensity from 3 to 10 mm Hg. The patients tested ranged from 1 month to 24 years of age, with a median age of 2.7 years. Sensory testing was completed in 92% of patients. Patients who had an LAR at less than 4 mm Hg rarely if ever had episodes of laryngeal penetration or aspiration. Those with an LAR at 4 to 10 mm Hg had variable amounts of aspiration and laryngeal penetration. The LAR could not be elicited at the maximum level of intensity (10 mm Hg) in 22 patients, who demonstrated severe laryngeal penetration and/or aspiration. Elevated laryngopharyngeal sensory thresholds correlated positively with previous clinical diagnoses of recurrent pneumonia, neurologic disorders, and gastroesophageal reflux, and correlated positively with findings of pooled secretions, laryngeal penetration, and aspiration. Laryngopharyngeal sensory testing in children is feasible and correlative.Keywords
This publication has 16 references indexed in Scilit:
- Laryngopharyngeal Sensory Discrimination Testing and the Laryngeal Adductor ReflexAnnals of Otology, Rhinology & Laryngology, 1999
- FEESST: A New Bedside Endoscopic Test of the Motor and Sensory Components of SwallowingAnnals of Otology, Rhinology & Laryngology, 1998
- Fiberoptic Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST) in Healthy ControlsDysphagia, 1998
- Silent Laryngopharyngeal Sensory Deficits after StrokeAnnals of Otology, Rhinology & Laryngology, 1997
- Supraglottic and Pharyngeal Sensory Abnormalities in Stroke Patients with DysphagiaAnnals of Otology, Rhinology & Laryngology, 1996
- Age-Related Changes in Pharyngeal and Supraglottic SensationAnnals of Otology, Rhinology & Laryngology, 1994
- Air Pulse Quantification of Supraglottic and Pharyngeal Sensation: A New TechniqueAnnals of Otology, Rhinology & Laryngology, 1993
- Videoendoscopic Evaluation of patients with dysphagia: An adjunct to the modified barium swallowOtolaryngology -- Head and Neck Surgery, 1991
- Fiberoptic endoscopic examination of swallowing safety: A new procedureDysphagia, 1988
- The cytologic composition of primate laryngeal chemosensory corpusclesJournal of Anatomy, 1980