Variability of the Pressure Measurements Exerted by the Tip of Laryngoscope During Laryngeal Sensory Testing: A Clinical Demonstration Purpose Clinicians often test laryngeal sensation by touching the laryngeal mucosa with the tip of a flexible laryngoscope. However, the pressure applied to the larynx by using this touch method is unknown, and the expected responses elicited by this method are uncertain. The variability in pressure delivered by clinicians using ... Clinical Focus
Clinical Focus  |   August 15, 2017
Variability of the Pressure Measurements Exerted by the Tip of Laryngoscope During Laryngeal Sensory Testing: A Clinical Demonstration
 
Author Affiliations & Notes
  • Asako Kaneoka
    Department of Speech, Language & Hearing Sciences, Boston University, Sargent College, MA
    The University of Tokyo Hospital Rehabilitation Center, Japan
  • Jessica M. Pisegna
    Department of Speech, Language & Hearing Sciences, Boston University, Sargent College, MA
    Department of Otolaryngology–Head and Neck Surgery, Boston University Medical Center, MA
  • Gintas P. Krisciunas
    Department of Otolaryngology–Head and Neck Surgery, Boston University Medical Center, MA
  • Takaharu Nito
    Department of Otolaryngology, The University of Tokyo School of Medicine, Japan
  • Michael P. LaValley
    Department of Biostatistics, Boston University School of Public Health, MA
  • Cara E. Stepp
    Department of Speech, Language & Hearing Sciences, Boston University, Sargent College, MA
    Department of Otolaryngology–Head and Neck Surgery, Boston University Medical Center, MA
  • Susan E. Langmore
    Department of Speech, Language & Hearing Sciences, Boston University, Sargent College, MA
    Department of Otolaryngology–Head and Neck Surgery, Boston University Medical Center, MA
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Asako Kaneoka: asakokaneoka@gmail.com
  • Editor: Krista Wilkinson
    Editor: Krista Wilkinson×
  • Associate Editor: Julie Barkmeier-Kraemer
    Associate Editor: Julie Barkmeier-Kraemer×
Article Information
Clinical Focus
Clinical Focus   |   August 15, 2017
Variability of the Pressure Measurements Exerted by the Tip of Laryngoscope During Laryngeal Sensory Testing: A Clinical Demonstration
American Journal of Speech-Language Pathology, August 2017, Vol. 26, 729-736. doi:10.1044/2017_AJSLP-16-0006
History: Received January 9, 2016 , Revised June 17, 2016 , Accepted May 5, 2017
 
American Journal of Speech-Language Pathology, August 2017, Vol. 26, 729-736. doi:10.1044/2017_AJSLP-16-0006
History: Received January 9, 2016; Revised June 17, 2016; Accepted May 5, 2017

Purpose Clinicians often test laryngeal sensation by touching the laryngeal mucosa with the tip of a flexible laryngoscope. However, the pressure applied to the larynx by using this touch method is unknown, and the expected responses elicited by this method are uncertain. The variability in pressure delivered by clinicians using the touch method was investigated, and the subject responses to the touches were also reported.

Methods A fiberoptic pressure sensor passed through the working channel of a laryngoscope, with its tip positioned at the distal port of the channel. Two examiners each tested 8 healthy adults. Each examiner touched the mucosa covering the left arytenoid 3 times. The sensor recorded the pressure exerted by each touch. An investigator noted subject responses to the touches. From the recorded videos, the absence or presence of the laryngeal adductor reflex in response to touch was judged.

Results Pressure values obtained for 46 of the 48 possible samples ranged from 17.9 mmHg to the measurement ceiling of 350.0 mmHg. The most frequently observed response was positive subject report followed by the laryngeal adductor reflex.

Conclusion Pressure applied to the larynx by using the touch method was highly variable, indicating potential diagnostic inaccuracy in determining laryngeal sensory function.

Acknowledgments
This study was supported by the Dudley Allen Sargent Research Fund from the Sargent College of Health and Rehabilitation Sciences (awarded to A. Kaneoka). The authors thank Edel McNally, Rebecca Scheel, and Michael J. Walsh for their clinical advice and grading of the samples. We also thank Katey Felling for editorial assistance and Joe Lavoie of Pentax Medical for support with technical issues.
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