Senior Scholars Program

Title

Sensory dysphagia: A case series and proposed classification of an under recognized swallowing disorder

UMMS Affiliation

Department of Otolaryngology; Department of Neurology; School of Medicine; Senior Scholars Program

Faculty Mentor

David Paydarfar

Publication Date

2019-05-01

Document Type

Article

Disciplines

Diagnosis | Digestive System Diseases | Medical Education | Nervous System Diseases | Otorhinolaryngologic Diseases

Abstract

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.

Keywords

dysphagia, flexible endoscopic evaluation of swallowing with sensory testing, globus pharyngeus, internal superior laryngeal nerve, sensory dysphagia

DOI of Published Version

10.1002/hed.25588

Source

Head Neck. 2019 May;41(5):E71-E78. doi: 10.1002/hed.25588. Epub 2019 Jan 8. Link to article on publisher's site

Journal/Book/Conference Title

Head and neck

Comments

Laura Santoso participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID

30620442

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