Monell Chemical Senses Center, Philadelphia, Pennsylvania; Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
J Voice. 2023 Mar;37(2):234-244. doi: 10.1016/j.jvoice.2020.12.029. Epub 2021 Jan 15.
Inhaled airborne stimuli are associated with laryngeal disorders affecting respiration. Clinically, several themes emerged from the literature that point to specific gaps in the understanding and management of these disorders. There is wide variation in the types of airborne stimuli that trigger symptoms, lack of standardization in provocation challenge testing using airborne stimuli, and vague reporting of laryngeal symptoms. Scientifically, evidence exists outside the field of voice science that could prove useful to implement among patients with impaired laryngeal-respiration. To expand this area of expertise, here we provide a thematic overview of relevant evidence and methodological tools from the discipline of chemosensory sciences. This review provides distinctions across the three chemosensory systems of olfaction, trigeminal chemesthesis, and gustation, guidance on selecting and delivering common chemosensory stimuli for clinical testing, and methods of quantifying sensory experiences using principles of human psychophysics. Investigating the science of chemosensation reveals that laryngeal responses to inhaled airborne stimuli have explanations involving physiological mechanisms as well as higher cognitive processing. Fortunately, these findings are consistent with current pharmacological and nonpharmacological interventions for impaired laryngeal-respiration. Based on the close relationships among inhaled airborne stimuli, respiration, and laryngeal function, we propose that new perspectives from chemosensory sciences offer opportunities to improve patient care and target areas of future research.
吸入的空气传播刺激物与影响呼吸的喉部疾病有关。临床上，文献中出现了几个主题，这些主题表明人们对这些疾病的理解和管理存在特定的差距。触发症状的空气传播刺激物的类型存在广泛差异，使用空气传播刺激物进行激发挑战测试缺乏标准化，以及对喉部症状的报告模糊。从嗓音科学领域之外的科学证据表明，这些证据可能对有受损喉呼吸的患者有用。为了扩展这一专业领域，我们在这里提供来自化学感觉科学领域的相关证据和方法工具的主题概述。本综述提供了嗅觉、三叉神经化学感觉和味觉这三个化学感觉系统之间的区别，指导如何选择和提供用于临床测试的常见化学感觉刺激物，以及使用人类心理物理学原理量化感觉体验的方法。对化学感觉科学的研究表明，吸入的空气传播刺激物引起的喉部反应涉及生理机制以及更高的认知处理。幸运的是，这些发现与目前用于受损喉呼吸的药理学和非药理学干预措施一致。基于吸入的空气传播刺激物、呼吸和喉部功能之间的密切关系，我们提出化学感觉科学的新观点为改善患者护理和确定未来研究领域提供了机会。
