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Laryngeal Sensory Dysfunction in Laryngeal Hypersensitivity Syndrome.
MedLine Citation:
PMID:  23617471     Owner:  NLM     Status:  Publisher    
BACKGROUND AND OBJECTIVE: Diseases associated with laryngeal dysfunction include chronic refractory cough (CRC), paradoxical vocal fold movement (PVFM), muscle tension dysphonia (MTD) and globus pharyngeus. We hypothesised the presence of a common sensory laryngeal dysfunction, the 'laryngeal hypersensitivity' syndrome, in these conditions. The aim of the study was to compare symptoms and sensory function in patients with CRC, PVFM, MTD and globus. METHODS: The 103 participants included healthy controls(n=13) and 4 case groups: CRC(n=33), PVFM(n=28), globus pharyngeus(n=11), and MTD(n=18). Participants completed self-report questionnaires: Symptom Frequency and Severity Scale, Voice Handicap Index and the Laryngeal Paraesthesia Questionnaire; and quantitative sensory testing: capsaicin cough reflex sensitivity, hypertonic saline challenge, the timed swallow test, acoustic voice testing, cough frequency monitor and a voice stress test. RESULTS: All case groups reported a high symptom burden in comparison to controls. The case groups showed a similar pattern of symptoms, with impairment in each of the cough, respiration, vocal and upper airway symptom domains. Objective testing revealed significant sensory impairment in the case groups compared to controls and also showed an overlap in sensory dysfunction between the four case groups. Furthermore there was cross sensory stimulation of symptoms whereby stimulation of a particular response resulted in symptoms in another domain. CONCLUSIONS: These discrete clinical laryngeal syndromes display considerable overlap in their clinical features and a common sensory dysfunction, supporting the 'laryngeal hypersensitivity' hypothesis. Reconceptualising functional laryngeal disorders as a form of laryngeal hypersensitivity syndrome provides an alternative approach to management of these perplexing conditions.
Anne E Vertigan; Sarah L Bone; Peter G Gibson
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-4-26
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-4-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
Priority Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia; Speech Pathology Department, John Hunter Hospital, Newcastle, Australia; Hunter Medical Research Institute, John Hunter Hospital, Newcastle, Australia.
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