• Orlando Parise Junior, Roberto Elias Villela Miguel, Daniela Luci D'Aquino Gomes, Antonio Douglas Menon, and Kiyoshi Hashiba.
• Hospital Sírio-Libanês, São Paulo, Brazil. oparise@uol.com.br
• Sao Paulo Med J. 2004 Sep 2; 122 (5): 200203200-3.

ContextLaryngeal sensitivity is important in the coordination of swallowing coordination and avoidance of aspiration.ObjectiveTo briefly review the physiology of swallowing and report on our experience with laryngeal sensitivity evaluation among patients presenting dysphagia.Type Of StudyProspective.SettingEndoscopy Department, Hospital Sírio-Libanês.MethodsClinical data, endoscopic findings from the larynx and the laryngeal sensitivity, as assessed via the Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST) protocol (using the Pentax AP4000 system), were prospectively studied. The chi-squared and Student t tests were used to compare differences, which were considered significant if p < or = 0.05.ResultsThe study included 111 patients. A direct association was observed for hyperplasia and hyperemia of the posterior commissure region in relation to globus (p = 0.01) and regurgitation (p = 0.04). Hyperemia of the posterior commissure region had a direct association with sialorrhea (p = 0.03) and an inverse association with xerostomia (p = 0.03). There was a direct association between severe laryngeal sensitivity deficit and previous radiotherapy of the head and neck (p = 0.001).DiscussionThese data emphasize the association between proximal gastroesophageal reflux and chronic posterior laryngitis, and suggest that decreased laryngeal sensitivity could be a side effect of radiotherapy.ConclusionsEven considering that these results are preliminary, the endoscopic findings from laryngoscopy seem to be important in the diagnosis of proximal gastroesophageal reflux. Study of laryngeal sensitivity may have the potential for improving the knowledge and clinical management of dysphagia.

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