2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

Laryngeal sensory dysfunction

Figure 2 (a) Timed swallow test, (b) Dys- phonia Severity Index, (c) C5dose and (d) Dose-response slope for the CRC, PVFM, globus and MTD groups. CRC, chronic refractory cough; MTD, muscle tension dysphonia; PVFM, paradoxical vocal fold movement.

Table 5 Cross-stimulus responses to quantitative sensory testing

Case groups n = 90

Controls n = 13

P

Voice stress testing Cough

- 0.1 (0.7) 0.3 (0.6) 0.2 (0.2) 0.6 (0.9) - 0.1 (0.2) 0.3 (0.6) 12.7 (7.3)

Change in UTC

0.8 (2.9) 3.0 (3.1) 1.3 (2.3) 2.6 (2.7) 0.5 (2.4) 3.1 (2.7)

0.015

< 0.001

Worst urge to cough Change in MBS scores

Dyspnoea

0.001

< 0.001

Worst MBS

Laryngeal paraesthesia

Change in BLP

0.035

< 0.001 < 0.001

Worst BLP

Dysphonia

Change in CAPE-V scores

33.5 (21.7)

Cough reflex testing Dysphonia

< 0.001

CAPE-V change after capsaicin cough test

32.2 (26.7)

6.8 (7.6)

Higher change scores denote more deterioration; Lower ‘worst’ scores denote more severe sensation; All scores M (SD). BLP, Borg Laryngeal Paraesthesia Scale; CAPE-V, Consensus Auditory Perceptual Evaluation–Voice; MBS, Modified Borg Scale; UTC, urge to cough.

REFERENCES

describe sensory symptoms and function in a range of laryngeal conditions. The results show that impaired sensation with central reflex sensitization is part of the symptom profile of these conditions. There is potential for neuromodulatory agents to be used in their management. Acknowledgements This study was supported by the Hunter Research Medical Insti- tute. The authors would also like to acknowledge the assistance of Dr Nicole Ryan for assistance with cough reflex sensitivity testing.

1 Vertigan A, Theodoros D, Gibson P et al . Voice and upper airway symptoms in people with chronic cough and paradoxical vocal fold movement. J. Voice 2007; 21 : 361–83. 2 Ryan N, Gibson P. Cough reflex hypersensitivity and upper airway hyperresponsiveness in vocal cord dysfunction with chronic cough. Respirology 2006; 11 (Suppl. 2): A48. 3 Andrianopoulous M, Gallivan G, Gallivan K. PVCM, PVCD, EPL and Irritable Larynx Syndrome: what are we talking about and how do we treat it? J. Voice 2000; 14 : 607–18. 4 Morrison M, Rammage L, Emami A. The irritable larynx syn- drome. Journal of Voice. 1999; 13 : 447–55.

© 2013 The Authors Respirology © 2013 Asian Pacific Society of Respirology

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