assessment of laryngopharyngeal sensation: cancer survivor cohort

Conditions: Presbylarynx; Aspiration; Spasmodic Dysphonia; Globus Pharyngeus; Larynx Paralysis; Laryngeal Disease; Vocal Cord Paralysis; Iatrogenic Injury; Sensory Neuropathy

Summary: a previous study completed in 2022 (nct05158179) was conducted using cohorts of healthy controls, and adults with general laryngopharyngeal disorders. this study will expand on the previous research to include a separate cohort of adults being seen in clinic for an existing laryngopharyngeal disorder resulting from previous radiation or other cancer treatments.

primary objectives: i. laryngeal sensation as measured by elicitation of laryngeal adductor reflex (lar). ii. to compare the elicitation of laryngeal adductor reflex (lar) threshold/probability to the penetration-aspiration scale (pas). secondary objectives: i. to assess patient-reported laryngeal sensation (prls) following stimulus and perceptual strength. ii. to assess laryngopharyngeal responses (e.g., cough, gag, swallow) following stimulus. iii. to assess patient reported outcomes (pros). exploratory objectives: i. to compare the elicitation of laryngeal adductor reflex (lar) threshold/probability to: * modified barium swallow (mbs) study kinematics; * mbs dynamic imaging grade of swallowing toxicity (mbs digest); * md anderson dysphagia inventory patient reported outcomes measure (mdadi proms); * dynamic imaging grade of swallowing toxicity for flexible endoscopic evaluation of swallowing (digest-fees) * flexible endoscopic evaluation of swallowing visual analysis of swallowing efficiency and safety (fees vases). outline: participants receiving care at university of california, san francisco (ucsf) for an existing laryngopharyngeal disorder resulting from previous radiation or other cancer treatments will undergo laryngopharyngeal sensory testing at a single visit. there will be up to 2 years of medical record follow up after completing the main study. data collected from this separate cohort may be compared with historical data collected in a previous study (nct05158179).

Eligibility criteria:
inclusion criteria: 1. age \<=18 years. 2. individuals without a laryngopharyngeal disorder (health controls) or with a laryngopharyngeal disorder. laryngopharyngeal disorder includes but is not limited to: presbylarynx, aspiration; spasmodic dysphonia; globus pharynges; vocal fold paralysis; iatrogenic injury to the larynx; muscle tension dysphonia; neurogenic dysphagia; laryngeal sensory neuropathy; and laryngopharyngeal disorders resulting from prior radiation therapy in individuals with a history of head and neck cancer who have completed radiation therapy as primary or adjuvant cancer treatment 3. ability and willingness to comply with study procedures. 4. ability to understand a written informed consent document, and the willingness to sign it. exclusion criteria: 1. non-english speaking. 2. laryngopharyngeal structures are not accessible on exam. 3. known contraindication to any study-related procedure, or history of being unable to tolerate laryngoscopy. 4. vocal fold immobility or severe hypomobility on adduction. 5. for head and neck cancer survivors only: currently undergoing radiation therapy for head and neck cancer (i.e., primary/adjuvant radiation therapy treatment plan is not yet completed).

Keywords: cancer survivors previous cancer treatment laryngopharyngeal disorders