Pharyngo-UES contractile reflex in patients with posterior laryngitis

Seckin O. Ulualp, Robert J. Toohill, Mark Kern, Reza Shaker

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background: Earlier studies have shown that stimulation of the human pharynx by injection of minute amounts of water stimulates the pharyngoUES contractile reflex. It has been suggested that this reflex may be activated during pharyngeal reflux of gastric and/or esophageal content, thus increasing the UES pressure and possibly preventing further entry of the refluxate into the pharynx. However, the integrity of this reflex in patients with posterior laryngitis has not been studied. Aim: Evaluate the pharyngo- UES contractile reflex in a group of patients with objective findings of posterior laryngitis. Methods: Fourteen consecutive patients with posterior laryngitis (mean age, 48 ± 6 y) and 13 healthy volunteers (mean age, 53 ± 6 y) were studied by concurrent pharyngeal water stimulation and UES manometry. Results: The threshold volume required to evoke the pharyngo-UES contractile reflex in the laryngitis group (0.4 ± 0.05 mL) was significantly higher than that of the control (0.2 ± 0.04 mL) (P < .05). Following stimulation of the pharyngo-UES contractile reflex, the maximum postinjection pressure in patients (75 ± 6 mm Hg) was similar to that of the controls (78 ± 6 mm Hg). The percent increase in UES pressure following stimulation of the reflex in the laryngitis group (99% ± 15%) was significantly higher than that of controls (55% ± 11%) (P < .05). Conclusions: Compared with normal controls, a significantly larger volume of liquid is required to trigger this reflex in patients with posterior laryngitis. When triggered, the maximum UES pressure induced by the pharyngo-UES contractile reflex is similar between the two groups. These findings suggest an altered afferent sensory limb of this reflex in patients with posterior laryngitis.

Original languageEnglish (US)
Pages (from-to)1354-1357
Number of pages4
JournalLaryngoscope
Volume108
Issue number9
DOIs
StatePublished - Sep 1998

Fingerprint

Laryngitis
Reflex
Pressure
Pharynx
Water
Manometry
Stomach
Healthy Volunteers
Extremities

Keywords

  • Airway protection
  • Reflux laryngitis
  • Upper esophageal sphincter

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Pharyngo-UES contractile reflex in patients with posterior laryngitis. / Ulualp, Seckin O.; Toohill, Robert J.; Kern, Mark; Shaker, Reza.

In: Laryngoscope, Vol. 108, No. 9, 09.1998, p. 1354-1357.

Research output: Contribution to journalArticle

Ulualp, Seckin O. ; Toohill, Robert J. ; Kern, Mark ; Shaker, Reza. / Pharyngo-UES contractile reflex in patients with posterior laryngitis. In: Laryngoscope. 1998 ; Vol. 108, No. 9. pp. 1354-1357.
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abstract = "Background: Earlier studies have shown that stimulation of the human pharynx by injection of minute amounts of water stimulates the pharyngoUES contractile reflex. It has been suggested that this reflex may be activated during pharyngeal reflux of gastric and/or esophageal content, thus increasing the UES pressure and possibly preventing further entry of the refluxate into the pharynx. However, the integrity of this reflex in patients with posterior laryngitis has not been studied. Aim: Evaluate the pharyngo- UES contractile reflex in a group of patients with objective findings of posterior laryngitis. Methods: Fourteen consecutive patients with posterior laryngitis (mean age, 48 ± 6 y) and 13 healthy volunteers (mean age, 53 ± 6 y) were studied by concurrent pharyngeal water stimulation and UES manometry. Results: The threshold volume required to evoke the pharyngo-UES contractile reflex in the laryngitis group (0.4 ± 0.05 mL) was significantly higher than that of the control (0.2 ± 0.04 mL) (P < .05). Following stimulation of the pharyngo-UES contractile reflex, the maximum postinjection pressure in patients (75 ± 6 mm Hg) was similar to that of the controls (78 ± 6 mm Hg). The percent increase in UES pressure following stimulation of the reflex in the laryngitis group (99{\%} ± 15{\%}) was significantly higher than that of controls (55{\%} ± 11{\%}) (P < .05). Conclusions: Compared with normal controls, a significantly larger volume of liquid is required to trigger this reflex in patients with posterior laryngitis. When triggered, the maximum UES pressure induced by the pharyngo-UES contractile reflex is similar between the two groups. These findings suggest an altered afferent sensory limb of this reflex in patients with posterior laryngitis.",
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AB - Background: Earlier studies have shown that stimulation of the human pharynx by injection of minute amounts of water stimulates the pharyngoUES contractile reflex. It has been suggested that this reflex may be activated during pharyngeal reflux of gastric and/or esophageal content, thus increasing the UES pressure and possibly preventing further entry of the refluxate into the pharynx. However, the integrity of this reflex in patients with posterior laryngitis has not been studied. Aim: Evaluate the pharyngo- UES contractile reflex in a group of patients with objective findings of posterior laryngitis. Methods: Fourteen consecutive patients with posterior laryngitis (mean age, 48 ± 6 y) and 13 healthy volunteers (mean age, 53 ± 6 y) were studied by concurrent pharyngeal water stimulation and UES manometry. Results: The threshold volume required to evoke the pharyngo-UES contractile reflex in the laryngitis group (0.4 ± 0.05 mL) was significantly higher than that of the control (0.2 ± 0.04 mL) (P < .05). Following stimulation of the pharyngo-UES contractile reflex, the maximum postinjection pressure in patients (75 ± 6 mm Hg) was similar to that of the controls (78 ± 6 mm Hg). The percent increase in UES pressure following stimulation of the reflex in the laryngitis group (99% ± 15%) was significantly higher than that of controls (55% ± 11%) (P < .05). Conclusions: Compared with normal controls, a significantly larger volume of liquid is required to trigger this reflex in patients with posterior laryngitis. When triggered, the maximum UES pressure induced by the pharyngo-UES contractile reflex is similar between the two groups. These findings suggest an altered afferent sensory limb of this reflex in patients with posterior laryngitis.

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