This study encompasses multiple diagnoses, procedures, VFI techniques, and methods of anesthesia. AIOLPs are exceptionally well tolerated by patients, resulting in extremely high completion and satisfaction rates.
Laryngeal framework surgeries are being performed with increasing frequency in the United States. The overall complication rate is slightly increased in the present study, but airway compromise and poor vocal outcome are decreased, and the need for revision surgery is unchanged. These findings suggest a continued high level of efficacy of these procedures.
Objectives: To evaluate laryngopharyngeal sensation at specific subsites using a novel adaptation of a buckling force aesthesiometer for delivery of calibrated tactile stimuli.Study Design: Cross-sectional. Methods: Twenty-two healthy adults (12 men, 10 women) were tested for responses to tactile forces, using 30-mm 6-0, 5-0, and 4-0 nylon monofilaments to map sensation of the aryepiglottic (AE) fold, lateral pyriform sinus (PS), and medial PS bilaterally. The outcome measures were the laryngeal adductor reflex (LAR) and patient reported rating of perceptual strength.Results: Rates of triggered LAR response grew monotonically with increasing tactile force at a mean (SD) stimulus duration of 663 ( 164) msec across all three subsites. The AE fold and medial PS had similar profiles and were the most responsive, while the lateral PS was the least responsive. Low force (6-0) response rate was ≤14% for all subsites. High force (4-0) response rate was 91% for AE fold and medial PS, and 23% for lateral PS. The perceptual strength gradient was in the lateral to medial trajectory.
Conclusion:Normative data for LAR response rates to low, medium, and high stimulation forces will be useful to assess sensory dysfunction in a variety of laryngopharyngeal disorders, including aspiration, dysphagia, chronic cough, and spasmodic dysphonia. In turn, that information will guide the creation of innovative treatments. LAR response profiles to low and high force stimuli will inform the development of screening tools to diagnose laryngopharyngeal hypersensitivity and hyposensitivity conditions.
This open label study using nimodipine for treatment of AVFP demonstrates tripling of the recovery rate of vocal fold motion compared with historical controls. Further study in a randomized, controlled manner is warranted.
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