ABEA014 - Expert Consensus Statement On The Use Of Swallowing Fluoroscopy In Adults From The American Broncho-esophagological Association
Friday, April 29, 2022
3:30 PM – 3:36 PM CT
Location: Landmark D
Shumon I Dhar, Nogah Nativ-Zeltzer, Heather Starmer, Linda N Morimoto, Lisa Evangelista, Ashli K O'Rourke, Mark Fritz Anais Rameau, Derrick Randall, Daniel J Cates, Jacqueline Allen, Gregory Postma, Maggie A Kuhn, Peter C Belafsky
UT Southwestern Medical Center; UC Davis Medical Center; Stanford University Medical Center; Medical University of South Carolina; University of Kentucky Medical Center; Weill Cornell Medical College; University of Auckland;8Medical College of Georgia
Assistant Professor UT Southwestern Medical Center Dallas, Texas
Objective : We assessed laryngopharyngeal sensory function in healthy adults through delivery of tactile stimuli using monofilaments.
Method: Cross-sectional study of 32 healthy adults (20 women, 17 aged>55 years old) was performed using four calibrated tactile stimuli (6-0, 5-0, 4.5-0, 4-0 nylon) delivered to three laryngopharyngeal subsites: false vocal fold (FVF), aryepiglottic (AE) fold, and lateral pyriform sinus (PS). Primary outcome was positive laryngeal adductor reflex (LAR). Secondary outcome was patient-reported perceptual strength. Analyses included repeated measures logistic and linear regression models, Fisher's exact and Mann-Whitney tests.
Results: (Table) Positive LAR was observed in 34%, 70%, and 94% at PS, AE, and FVF respectively. LAR rates were significantly associated with laryngopharyngeal subsite (p < 0.001), tactile force delivered (p < 0.001), and age with 5-0 at PS (p= 0.05) and 4.5-0 at AE (p= 0.045). With each ten years of age increase, there was an associated 19% reduction in odds of LAR (aOR=0.81, 95% CI [0.65, 1.02]; p=0.076). Mean perceptual strengths were 1.89, 2.51, 5.09 at PS, AE, and FVF respectively. Perceptual strength was significantly associated with subsite (p < 0.001), tactile force delivered (p=0.01), but not age. Each 10 years of age increase is associated with 0.26 [-0.02, 0.55] lower average on perceptual strength (p=0.066).
Conclusion: We expanded on previous work by examining a new intermediate force (4.5-0), new subsite (FVF), and an older cohort. This work allows objective laryngopharyngeal sensation assessment in other patient populations, such as those with dysphagia, and may guide treatment. Table: Laryngeal adductor reflex (LAR) rate and mean perceptual strength (MPS) in patients above or below 55 years of age class="MsoNormal"> **p <.05 using fisher’s exact test