Sensory dysphagia: A case series and proposed classification of an under recognized swallowing disorder
Department of Otolaryngology; Department of Neurology; School of Medicine; Senior Scholars Program
Diagnosis | Digestive System Diseases | Medical Education | Nervous System Diseases | Otorhinolaryngologic Diseases
BACKGROUND: Although sensory feedback is a vital regulator of deglutition, it is not comprehensively considered in the standard dysphagia evaluation. Difficulty swallowing secondary to sensory loss may be termed "sensory dysphagia" and may account for cases receiving diagnoses of exclusion, like functional or idiopathic dysphagia.
METHODS AND RESULTS: Three cases of idiopathic dysphagia were suspected to have sensory dysphagia. The patients had (1) effortful swallowing, (2) globus sensation, and (3) aspiration. Endoscopic sensory mapping revealed laryngopharyngeal sensory loss. Despite normal laryngeal motor function during voluntary maneuvers, laryngeal closure was incomplete during swallowing. The causes of sensory loss were identified: cranial neuropathy from Chiari malformation, immune-mediated neuronopathy, and nerve damage from prior traumatic intubation.
CONCLUSIONS: Sensory loss may cause dysphagia without primary motor dysfunction. Sensory dysphagia should be classified as a distinct form of swallowing motility disorder to improve diagnosis. Increasing awareness and developing appropriate assessment tools may advance dysphagia care.
dysphagia, flexible endoscopic evaluation of swallowing with sensory testing, globus pharyngeus, internal superior laryngeal nerve, sensory dysphagia
DOI of Published Version
Head Neck. 2019 May;41(5):E71-E78. doi: 10.1002/hed.25588. Epub 2019 Jan 8. Link to article on publisher's site
Head and neck
Santoso, Laura F.; Kim, Daniel Y.; and Paydarfar, David, "Sensory dysphagia: A case series and proposed classification of an under recognized swallowing disorder" (2019). University of Massachusetts Medical School. Senior Scholars Program. Paper 271.