Chronic laryngopharyngeal vagal neuropathy

Benninger, Michael S.; Campagnolo, Andréa Maria

doi:10.1016/j.bjorl.2018.04.001

Cited by 8 publications

(6 citation statements)

References 21 publications

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“…That is to say, reflux increases the sensitivity of cough or directly leads to cough onset. However, cough once again increases the relaxation reaction of esophageal sphincter, which leads to LPRD disease ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Correlation and Influencing Factors Between Laryngopharyngeal Reflux Disease and Sleep Status in Patients

Liu

Xiao

et al. 2022

Front. Surg.

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ObjectiveTo observe the correlation between laryngopharyngeal reflux disease (LPRD) and patients' sleep status, and to explore the related factors of LPRD.MethodsFour hundred and sixteen patients who visited the otorhinolaryngology clinic in our hospital from June 2019 to June 2021 were selected as the research subjects. According to the scale of reflux symptom index, the subjects were divided into a patients group (120 patients) with an the reflux symptom index (RSI) > 13 and a control group (296 patients) with an RSI ≤ 13 according to the RSI scale score. General patient information was collected. The sleep state and emotional state of patients in the two groups were evaluated, and the related influencing factors for LPRD were also evaluated. The correlation between sleep state and depression in LPRD patients was analyzed.ResultsFour hundred and sixteen patients were divided into patients group and control group according to RSI score, the ratio of the two groups was 1:2.47. In the patients group, the common symptoms of RSI score and the top three of the total score were as follows: Foreign body sensation in throat in 112 patients, 438 points; Keep voice clear in 108 patients, 381 points; Excessive phlegm or nasal discharge reflux in 101 patients, 348 points. The PSQI and HADS scores in the patients group were higher than those in the control group (t = 19.990, 13.007, 14.690, P all <0.001). Logistic regression analysis showed that high-fat diet and high PSQI score were the risk factors for the development of LPRD (P = 0.012, P = 0.007). According to the PSQI score, the patients in the patients group were divided into 35 patients with abnormal PSQI score, 85 patients with normal PSQI score, and the HADS scores of those with abnormal PSQI score were all lower than those with normal PSQI score (P > 0.05). The PSQI score of the patients in the patients group was positively correlated with the HADS score (r = 0.714, P = 0.013).ConclusionSleep disorder may lead to the occurrence or aggravation of anxiety and depression in patients with LPRD, and it is an independent risk factor for the development of LPRD. Clinical attention to the treatment of sleep disorders in patients with LPRD may be conducive to improving the efficacy of LPRD.

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Section: Discussionmentioning

confidence: 99%

Correlation and Influencing Factors Between Laryngopharyngeal Reflux Disease and Sleep Status in Patients

Liu

Xiao

et al. 2022

Front. Surg.

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Section: Diagnostic and Clinical Classifications Of Uctsmentioning

confidence: 99%

“…Hypersensitisation of aerodigestive structures is a common theme among symptom theories related to UCTS 11 15 51 66 91–98. Cough hypersensitivity syndrome (CHS) and laryngeal hypersensitivity and diagnoses which typify this pathophysiological pattern, reinforced by emerging research 10 15 22 51 66 71 91 92 97–103. The core understanding implicates sensory dysregulation of aerodigestive tract or related reflexes in symptom emergence, most notably cough and globus sensation 92 104–108.…”

Section: Diagnostic and Clinical Classifications Of Uctsmentioning

confidence: 99%

Practical multidisciplinary framework for the assessment and management of patients with unexplained chronic aerodigestive symptoms

Quigley,

Mistry,

Vasant

et al. 2023

BMJ Open Gastroenterol

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ObjectivePatients experiencing unexplained chronic throat symptoms (UCTS) are frequently referred to gastroenterology and otolaryngology outpatient departments for investigation. Often despite extensive investigations, an identifiable structural abnormality to account for the symptoms is not found. The objective of this article is to provide a concise appraisal of the evidence-base for current approaches to the assessment and management of UCTS, their clinical outcomes, and related healthcare utilisation.DesignThis multidisciplinary review critically examines the current understanding of aetiological theories and pathophysiological drivers in UCTS and summarises the evidence base underpinning various diagnostic and management approaches.ResultsThe evidence gathered from the review suggests that single-specialty approaches to UCTS inadequately capture the substantial heterogeneity and pervasive overlaps among clinical features and biopsychosocial factors and suggests a more unified approach is needed.ConclusionDrawing on contemporary insights from the gastrointestinal literature for disorders of gut–brain interaction, this article proposes a refreshed interdisciplinary approach characterised by a positive diagnosis framework and patient-centred therapeutic model. The overarching aim of this approach is to improve patient outcomes and foster collaborative research efforts.

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“…Consequently, various stimuli such as acids may trigger the symptoms. This may be accompanied by paradoxical vocal fold movements as part of a syndrome of irritated larynx, in which hypersensitivity of afferent reflexes is a common mechanism (19). Neuropathy of the vagus nerve may also affect other motor branches of the vagus nerve and cause paresis or paralysis of the vocal folds, paradoxical vocal fold movements, or other sensory branches causing chronic cough and other symptoms such as scratchy throat, sore throat, laryngeal paresthesias, and laryngospasm.…”

Section: Vagal Neuropathymentioning

confidence: 99%

Cough as a neurological sign: Does it worth it?

Al‐Biltagi¹,

Bediwy²,

Saeed³

2021

Preprint

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Cough is one of the most common complaints that lead patients to see a doctor. It is not only a basic respiratory sign but also an important neurological sign. There are 3 main types of cough: reflex cough (type I), voluntary cough (type II), and evoked cough (type III). Reflex cough sensitivity may be increased in many neurological disorders, such as space-occupying lesion of the brainstem, medullary lesions secondary to type I Chiari malformations, tics disorders such as Tourette’s syndrome, somatic cough, neurodegenerative disorders of the cerebellum, and chronic vagal neuropathy due to allergic and nonallergic diseases. On the other hand, cough sensitivity decreases in the cerebral hypoxia, cerebral hemispheric stroke with a brainstem shock, dementia due to Lewy body disease, Parkinson’s disease, amyotrophic lateral sclerosis, multiple sclerosis, and peripheral neuropathy such as hereditary sensory and autonomic neuropathy type IV, diabetic neuropathy, vitamin B12, and folate deficiency. The ear-cough reflex of Arnold’s nerve, syncopal cough, cough headache, opioid associated cough and cough-anal reflex are signs that can help in the diagnosis of underlying neurological disorders. The cough reflex test is a quick, easy, and inexpensive test that can be performed during the cranial nerve exam. In this article, we have discussed cough reflex testing and various neurological disorders that increase or decrease cough sensitivity.

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Chronic laryngopharyngeal vagal neuropathy

Cited by 8 publications

References 21 publications

Correlation and Influencing Factors Between Laryngopharyngeal Reflux Disease and Sleep Status in Patients

Correlation and Influencing Factors Between Laryngopharyngeal Reflux Disease and Sleep Status in Patients

Practical multidisciplinary framework for the assessment and management of patients with unexplained chronic aerodigestive symptoms

Cough as a neurological sign: Does it worth it?

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