Laryngopharyngeal sensory deficits as a predictor of aspiration

OBJECTIVE: This study evaluates whether patients with severe sensory defici ts in the hypopharynx are at increased risk for aspiration and determines t he relationship between pharyngeal muscular weakness and hypopharyngeal sen sory deficits. STUDY DESIGN AND SETTING: Forty patients with dysphagia who underwent flexi ble endoscopic evaluation of swallowing with sensory testing were prospecti vely divided into 2 groups. One group included patients with severe sensory deficits determined by an absent laryngeal adductor reflex and the other w ith normal sensitivity Subjects were given liquid and puree consistencies a nd were evaluated for aspiration as well as pharyngeal muscle contraction. RESULTS: The differences in incidence of aspiration and pharyngeal muscular weakness between the 2 groups were significant (P < 0.001 Fisher's exact t est). CONCLUSION: There is a strong association between motor function deficits a nd hypopharyngeal sensory deficits. SIGNIFICANCE: The association of sensory loss and motor deficits together w ith the use of flexible endoscopic evaluation of swallowing with sensory te sting can predict those patients who are at highest risk for aspiration.