Vol.99 No.3 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 3 March 2006
Prediction of Aspiration Pneumonia by Laryngopharyngeal
Sensory Testing under Flexible Endoscopy
Satoshi Ikegami, Kazuhiko Shoji, Shinji Suzuki, Yo Kishimoto,
Tsuyoshi Kojima and Atsuhito Takahashi
(Tenri Hospital)
Objective: This study's aim was to evaluate the relation between sensory deficits of different parts of laryngopharyngeal mucosa and the incidence of aspiration pneumonia.
Study design and setting: 24 patients (20 male, 4 female; mean age of 75 years old) were examined. They had laryngeal penetration and aspiration during swallowing with water under flexible endoscopic evaluation. Different parts of mucosa such as on the apex of the epiglottis, on the root of the tongue, on the arytenoids, and above the anterior commissure were stimulated with a thin silicon tube attached to the tip of a flexible endoscope. When the swallowing reflex or cough reflex was immediately caused by contact stimulation on a part, it was judged that the sense of that part was normal. And when reflex was not caused, it was judged that that part had a sensory deficit.
After examination of the sense of each laryngopharyngeal part by the above method, subjects were followed under oral intake nutrition instead of the presence of aspiration. Then, subjects were divided into 2 groups according to whether they had an episode of aspiration pneumonia or not, and the results of contact stimulation with the silicon tube were compared between groups.
Results: The reflex caused by contact stimulation to the larynx above the anterior commissure by the above method was judged to be normal in all cases.
It was significantly confirmed that the presence of sensory deficits in the apex of the epiglottis was different between the two groups divided by the presence of aspiration pneumonia (p＜0.05).
Conclusion: Accurate prediction of aspiration pneumonia could be performed with our simple contact stimulation method to the apex of the epiglottis.
Key words : aspiration pneumonia, epiglottis, silicon tube, contact stimulation, sensory deficit, flexible endoscopy