Management of chronic laryngopharyngeal neuropathy in the United States and Europe

Examining the Influence of Chemosensation on Laryngeal Health and Disorders

Inhaled airborne stimuli are associated with laryngeal disorders affecting respiration. Clinically, several themes emerged from the literature that point to specific gaps in the understanding and management of these disorders. There is wide variation in the types of airborne stimuli that trigger symptoms, lack of standardization in provocation challenge testing using airborne stimuli, and vague reporting of laryngeal symptoms. Scientifically, evidence exists outside the field of voice science that could prove useful to implement among patients with impaired laryngeal-respiration. To expand this area of expertise, here we provide a thematic overview of relevant evidence and methodological tools from the discipline of chemosensory sciences. This review provides distinctions across the three chemosensory systems of olfaction, trigeminal chemesthesis, and gustation, guidance on selecting and delivering common chemosensory stimuli for clinical testing, and methods of quantifying sensory experiences using principles of human psychophysics. Investigating the science of chemosensation reveals that laryngeal responses to inhaled airborne stimuli have explanations involving physiological mechanisms as well as higher cognitive processing. Fortunately, these findings are consistent with current pharmacological and nonpharmacological interventions for impaired laryngeal-respiration. Based on the close relationships among inhaled airborne stimuli, respiration, and laryngeal function, we propose that new perspectives from chemosensory sciences offer opportunities to improve patient care and target areas of future research.

Laryngeal Sensory Symptoms in Spasmodic Dysphonia

OBJECTIVE

The purpose of this research was to determine whether an association between laryngeal hypersensitivity (LH) and spasmodic dysphonia (SD) exists using the LH Questionnaire (LHQ). This study also explored the prevalence of self-reported upper respiratory infection (URI) at the time of SD onset across SD phenotypes.

METHODS

Individuals with and without SD were recruited to complete an online survey measure. All respondents provided demographic information and completed the LHQ. Participants with SD were also asked to provide information about their diagnosed SD subtype and pattern of onset, including whether onset was associated with a URI. The percentage of respondents with and without SD who were classified with LH was determined based on the LHQ. Scores on the LHQ were also compared between the non-SD and the SD groups, as well as between SD phenotypes (adductor SD, abductor SD, and mixed)).

RESULTS AND CONCLUSIONS

Significant associations were found between ADSD and LH, mixed SD and LH, and URI at time of SD onset and increased severity of LH symptoms. These findings suggest that laryngeal sensory symptoms may potentially contribute to or result from motor spasms in SD and/or have implications for its pathophysiology.