Clayton Nicola A, Carnaby-Mann Giselle D, Peters Matthew J, Ing Alvin J
Speech Pathology Department, Concord Repatriation General Hospital, Concord, NSW, Australia.
Ear Nose Throat J. 2012 Sep;91(9):370, 372, 374 passim.
Patients with chronic obstructive pulmonary disease (COPD) may be at increased risk of aspiration secondary to impaired swallow function. One possible cause of this impairment is a reduction in laryngopharyngeal sensitivity. The relationship between COPD and laryngopharyngeal sensitivity has not been previously determined. We conducted a study to investigate the effect of COPD on laryngopharyngeal sensitivity by using laryngopharyngeal sensory discrimination testing (LPSDT). Our study population was made up of 20 adults (mean age: 71.7 yr) with clinically proven COPD and 11 healthy, age-matched controls. All 31 subjects underwent LPSDT with the use of an air-pulse stimulator via a nasendoscope. The threshold of laryngopharyngeal sensation was evaluated by measuring the amount of air pressure required to elicit the laryngeal adductor reflex (LAR). We found that the patients with COPD had a significantly higher LAR threshold than did the controls (p< 0.001). We conclude that patients with COPD have significantly less mechanosensitivity in the laryngopharynx. This sensory change may place patients with COPD at increased risk for aspiration.
慢性阻塞性肺疾病（COPD）患者可能因吞咽功能受损而出现误吸风险增加。这种功能受损的一个可能原因是喉咽敏感性降低。此前尚未确定COPD与喉咽敏感性之间的关系。我们进行了一项研究，通过使用喉咽感觉辨别测试（LPSDT）来调查COPD对喉咽敏感性的影响。我们的研究对象包括20名经临床证实患有COPD的成年人（平均年龄：71.7岁）和11名年龄匹配的健康对照者。所有31名受试者均通过鼻内镜使用空气脉冲刺激器进行LPSDT。通过测量引发喉内收肌反射（LAR）所需的气压来评估喉咽感觉阈值。我们发现，COPD患者的LAR阈值显著高于对照组（p<0.001）。我们得出结论，COPD患者的喉咽部机械敏感性明显降低。这种感觉变化可能使COPD患者发生误吸的风险增加。
