Aesthesiometer‐Based Testing for Laryngopharyngeal Hyposensitivity

xlomafota13 shared this article with you from Inoreader Aesthesiometer‐Based Testing for Laryngopharyngeal Hyposensitivity Via The Laryngoscope Objectives/Hypothesis To develop a method for threshold estimation of the laryngeal adductor reflex (LAR) response using Cheung-Bearelly monofilaments. Study Design Cross-sectional. Methods Twenty-two healthy adults (12 men, 10 women) were tested for LAR response outcome using 30 mm 5–0 and 4–0 nylon monofilaments. Tactile stimuli were delivered to the aryepiglottic (AE) fold and medial pyriform sinus (MPS). Dichotomous classifier features and performance (area under the curve (AUC)), the LAR response outcome agreement and disagreement matrix, and test–retest reliability were examined. From those data, a test protocol that would minimize patient burden to estimate the LAR triggering threshold was formulated. Results Classifier performance of 5–0 monofilament stimulation of the AE fold (sensitivity = 0.63, specificity = 0.63, PPV = 0.74, NPV = 0.25) and MPS (sensitivity = 0.45, specificity = 0.77, PPV = 0.74, NPV = 0.23,) was slightly below that of 4–0 monofilament stimulation of the AE fold (sensitivity = 0.82, specificity = 0.50, PPV = 0.82, NPV = 0.50) and MPS (sensitivity = 0.84, specificity = 0.64, PPV = 0.90, NPV = 0.56), based on AUC. LAR response outcome agreement for 5–0 and 4–0 stimulations was high (93%) for 5–0 positive response, but low (29%) for 5–0 negative response. Aesthesiometer test–retest reliability for LAR response outcome was excellent (Cronbach's alpha = 0.97). Conclusions Threshold estimation of the LAR response may be operationalized by adopting a decision tree protocol. For negative LAR response to initial 5–0 monofilament stimulation and positive response to subsequent 4–0 monofilament stimulation, the higher threshold is confirmed. Positive LAR response to 5–0 or 4–0 monofilament stimulation is expected in over 90% of asymptomatic adults. Negative LAR response to 4–0 monofilament stimulation identifies patients at risk for laryngopharyngeal hyposensitivity. Level of Evidence 3b Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.