EL ESTESIÓMETRO Y TELÉMETRO LÁSER ENDOSCÓPICO LARINGOFARÍNGEO (LPEER)

  • Luis Fernando Giraldo-Cadavid Fundación Neumológica Colombiana
  • Eliana Isabel Morales Sánchez Fundación Valle del Lili
Palabras clave: broncoscopia, deglución, endoscopios, estesiómetros, láseres de fibra, laringe, mecanoreceptor, diagnósticos médico, fibras ópticas, faringe, telemetro, reflejo, fiabilidad, repetibilidad y reproducibilidad de los resultados, precisión, exactitud diagnóstica, umbrales sensoriales

Resumen

El estesiómetro y telémetro láser endoscópico laringofaríngeo (LPEER) es un dispositivo diagnóstico para medir de forma cuantitativa los umbrales sensoriales mecánicos del tracto laringofaríngeo. La medición de estos umbrales tiene utilidad en el diagnóstico y evaluación de la respuesta al tratamiento de las enfermedades que cursan con alteraciones en la sensibilidad laringofaríngea, ya sea por hipoestesia o por hipersensibilidad. Entre las entidades que cursan con hipoestesia cabe mencionar la disfagia orofaríngea secundaria a enfermedad cerebrovascular, trauma craneoencefálico, posoperatorio de cirugía de corazón, diabetes y el síndrome de apnea-hipopnea obstructiva del sueño. En el otro extremo del espectro se encuentran entidades que cursan con hiperestesia laringofaríngea, como la laringe hipersensible o irritable, que es una causa frecuente de tos crónica de difícil control. El LPEER ha superado de manera satisfactoria las fases de diseño, calibración, verificación, validación en laboratorio y validación clínica en términos de precisión y exactitud de la medición de los umbrales sensoriales (estesiometría) mecánicos del tracto laringofaríngeo y puede llegar a constituirse en una herramienta útil para el diagnóstico y seguimiento de las patologías que cursan con alteraciones sensoriales laringofaríngeas.

Biografía del autor

Luis Fernando Giraldo-Cadavid, Fundación Neumológica Colombiana
MD. Internista. Neumólogo. Doctor en Investigación Médica Aplicada. Neumología Intervencionista. Fundación Neumológica Colombiana. Departamento de Epidemiología, Universidad de La Sabana. Miembro Correspondiente de la Academia Nacional de Medicina. Bogotá, Colombia
Eliana Isabel Morales Sánchez, Fundación Valle del Lili
MD. Internista. Neumóloga. Servicio de Neumología, Fundación Valle del Lili. Docente Departamento de Medicina Interna, Universidad ICESI. Cali, Colombia

Citas

1. Miyaji H, Hironaga N, Umezaki T, Hagiwara K, Shigeto H, Sawatsubashi M, Tobimatsu S, Komune S. Neuromagnetic detection of the laryngeal area: Sensoryevoked fields to air-puff stimulation. NeuroImage 2014; 88: 162-169.
2. Aviv JE, Kim T, Thomson JE, Sunshine S, Kaplan S, Close LG. Fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST) in healthy controls. Dysphagia 1998; 13: 87-92.
3. Aviv JE, Murry T, Zschommler A, Cohen M, Gartner C. Flexible endoscopic evaluation of swallowing with sneosry testing: patient characteristics and analysis of safety in 1,340 consecutive examinations. Ann Otol Rhinol Laryngol 2005; 114: 173-176.
4. Aviv JE, Spitzer J, Cohen M, Ma G, Belafsky PC, Close LG. Laryngeal adductor reflex and pharyngeal squeeze as predictors of laryngeal penetration and aspiration. The Laryngoscope 2002; 112: 338-341.
5. Hammer MJ, Barlow SM. Laryngeal somatosensory deficits in Parkinson’s disease: implications for speech respiratory and phonatory control. 2010. p. 401-409.
6. Dedhia RC, Rosen CA, Soose RJ. What is the role of the larynx in adult obstructive sleep apnea? Laryngoscope 2014; 124: 1029-1034.
7. Atkins BZ, Trachtenberg MS, Prince-Petersen R, Vess G, Bush EL, Balsara KR, Lin SS, Davis RD. Assessing Oropharyngeal Dysphagia After Lung Transplantation: Altered Swallowing Mechanisms and Increased Morbidity. Journal of Heart and Lung Transplantation 2007; 26: 1144-1148.
8. Morrison M, Rammage L, Emami AJ. The irritable larynx syndrome. Journal of Voice 1999; 13: 447-455.
9. Morice AH, Millqvist E, Belvisi MG, Bieksiene K, Birring SS, Chung KF, Dal Negro RW, Dicpinigaitis P, Kantar A, McGarvey LP, Pacheco A, Sakalauskas R, Smith JA. Expert opinion on the cough hypersensitivity syndrome in respiratory medicine. European Respiratory Journal 2014; 44: 1132-1148.
10. Eccles R, Lee PCL. Cough induced by airway vibration as a model of airway hyperreactivity in patients with acute upper respiratory tract infection. Pulmonary Pharmacology and Therapeutics 2004; 17: 337-342.
11. Kertscher B, Speyer R, Fong E, Georgiou AM, Smith M. Prevalence of Oropharyngeal Dysphagia in the Netherlands: A Telephone Survey. Dysphagia 2015; 30: 114120.
12. Jennum P, Riha RL. Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. European Respiratory Journal 2009; 33: 907-914.
13. Chung KF, Pavord ID. Prevalence, pathogenesis, and causes of chronic cough. Lancet 2008; 371: 1364-1374.
14. Relationship between Self-Reported Odor Intolerance and Sensitivity to Inhaled Capsaicin. 2014: 1623-1628.
15. Rofes L, Arreola V, López I, Martin A, Sebastián M, Ciurana A, Clavé P. Effect of surface sensory and motor electrical stimulation on chronic poststroke oropharyngeal dysfunction. Neurogastroenterology and Motility 2013; 25: 888-896.
16. Speyer R, Baijens L, Heijnen M, Zwijnenberg I. Effects of therapy in oropharyngeal dysphagia by speech and language therapists: A systematic review. Dysphagia 2010; 25: 40-65.
17. L LC. Central nervous system control of interactions between vocalization and respiration in mammals. Head & Neck 2011; 33: S21-S25.
18. Aviv JE, Debell M, Keen MS, Blitzer A, Martin JH. Air pulse quantification of supraglottic and pharyngeal sensation: A new technique. Annals of Otology, Rhinology & Laryngology 1993; 102: 777-780.
19. Hammer MJ. Design of a new somatosensory stimulus delivery device for measuring laryngeal mechanosensory detection thresholds in humans. IEEE Transactions on Biomedical Engineering 2009; 56: 1154-1159.
20. Cunningham JJ, Halum SL, Butler SG, Postma GN. Intraobserver and Interobserver Reliability in Laryngopharyngeal Sensory Discrimination Thresholds: A Pilot Study. Annals of Otology, Rhinology & Laryngology 2007; 116: 582-588.
21. Giraldo LF, Agudelo M, Arbulu M, Ortiz F, Burguete J, Fernández S. Controlling the variability of air-pulses to determine the thresholds of laryngeal-pharyngeal reflexes using a novel device. 13th IEEE International Conference on BioInformatics and BioEngineering, IEEE BIBE 2013 2013: 0-3.
22. Giraldo-Cadavid LF, Agudelo-Otálora LM, Burguete J, Arbulu M, Moscoso WD, Martínez F, Ortiz AsF, Díaz J, Pantoja JA, Rueda-Arango AsF, Fernández S. Design, development and validation of a new laryngo-pharyngeal endoscopic esthesiometer and range-finder based on the assessment of air-pulse variability determinants. BioMedical Engineering Online 2016; 15: 1-23.
23. Giraldo-Cadavid LF. Fiberoptic Endoscopic Evaluation of Swallowing with Sensory Test (FEESST) Protocol for the Validation of a Laryngo-pharyngeal Endoscopic Esthesiometer and Rangefinder (LPEER). [Serial online] 2013 Dec. 2013 [cited 22 Aug 2015]. Available from: https://upperairwaylfgiraldo.wordpress.com/about/.
24. Martin JH, Thomson JE, Aviv JE, Kim T, Diamond B, Sacco RL, Close LG. Laryngopharyngeal Sensory Discrimination Testing and the Laryngeal Adductor Reflex. Annals of Otology, Rhinology & Laryngology 1999; 108: 725-730.
25. McCool FD. Global Physiology and Pathophysiology of Cough. Chest 2006; 129: 48S-53S.
26. Ansuia Gupta MKSH, Akash D. The Etiology and Management of Gagging: A Review of Literature \n. International Journal of Dental Research & Development (IJDRD) 2012; 2: 54-62.
27. Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics 1977; 33: 159-174.
28. Bland JM, Altman DG. Measuring agreement in method comparison studies. Statistical Methods in Medical Research 1999; 8: 135-160.
29. Giraldo-Cadavid LF, Burguete J, Rueda F, Galvis AM, Castañeda N, Agudelo-Otálora LM, Moscoso WD, Páez N, Fernández S. Reliability of a laryngo-pharyngeal esthesiometer and a method for measuring laryngopharyngeal mechano-sensitivity in a prospectively recruited cohort of patients. European Archives of OtoRhino-Laryngology 2017; 274: 2861-2870.
30. Sharrack B, Hughes RAC, Soudain S, Dunn G. The psychometric properties of clinical rating scales used in multiple sclerosis. Brain 1999; 122: 141-159.
31. Hosmer DW, Lemeshow S. Assessing the Fit of the Model. 2013.
32. Giraldo-Cadavid LF, Leal-Leaño LR, León-Basantes GA, Bastidas AR, García R, Ovalle S, Abondano-Garavito JE. Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia. The Laryngoscope 2017; 127: 2002-2010.
33. Giraldo-Cadavid LF, Leal-Leaño LR, León-Basantes GA, Bastidas AR, García R, Ovalle S, Abondano-Garavito JE. Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia. Laryngoscope 2017; 127: 2002-2010.
34. Rosenbek JC, Robbins JA, Roecker PDEB, Coyle JL, Wood JL. A Penetration-Aspiration Scale. Dysphagia 1996; 98: 93-98.
35. Giraldo-Cadavid LF, Burguete J, Rueda F, Galvis AM, Castañeda N, Arbulu M, Balaguera JI, Páez N, Fernández S. Accuracy of a Laryngopharyngeal Endoscopic Esthesiometer (LPEER) for Evaluating Laryngopharyngeal Mechanosensitivity: A Validation Study in a Prospectively Recruited Cohort of Patients. Dysphagia 2018; 33: 15-25.
Publicado
2019-10-11
Sección
Artículos de Revisión