Laryngeal sensation and pharyngeal sensation are crucial for airway protection in swallowing. Previous research suggests that impaired laryngeal sensation and pooled salivary secretions are associated with increased risk of aspiration and post-swallow pharyngeal residue. [1][2][3][4][5][6] Risk factors for impaired sensation include mucosal damage and inflammation secondary to inhaled corticosteroid exposure, 5,7 or acid exposure in gastroesophageal reflux disease (GERD). [8][9][10][11] This study investigated the presence of and risk factors for laryngopharyngeal sensory impairment and its association with secretion pooling in adults with Chronic Obstructive Pulmonary Disease (COPD), given that dysphagia and aspiration can trigger COPD exacerbations. 12 Pharyngeal sensation is commonly assessed in cranial nerve examinations through elicitation of the pharyngeal gag reflex in response to mechanical stimulation of the posterior pharyngeal wall. 13 Laryngeal sensation can be assessed indirectly under laryngoscopy, via mechanical stimulation of the laryngeal mucosa using air puffs or light touch stimulation with the tip of a laryngoscope. 5,[14][15][16][17] Observations of motor responses in the form of pharyngeal contraction 13,18 or the laryngeal adductor reflex (LAR) are interpreted to indicate integrity of the afferent pathway. 14,15,19,20 Impaired LAR mechanosensitivity has been reported in individuals with COPD, 5