2002 Volume 6 Issue 2 Pages 158-166
A tapping test with a flexible laryngoscope (we use a fiberscope) was carried out for one hundred dysphagia patients．We evaluated the view of the remaining jelly，salivous collection in the pyriform fossa，salivous inflow into the larynx and sensation of tapping of the larynx．Laryngeal sensation was tested by tapping the center of the epiglottic inside (superior laryngeal nerve area) by the tip of the fiberscope．The results heard from patients (laryngeal sensation) were classified into two groups，the bad group，“recognizing nothing or only a little,” and the good group，“recognizing clearly， and exhibiting a swallowing reflex or escaping reaction.” We carried out examinations of the relationship between the position while eating，the view from the laryngoscopy (remaining jelly， salivous collection in the pyriform fossa， salivous inflow into the larynx)，the view from video-fluoroscopy (VF：remaining jelly， aspiration)， the grade of dysphagia (Fujishima) indicating ingestion，the incidence of pneumonia and laryngeal sensation．From these data，①Laryngeal sensation showed significant differences in aspiration， grade of dysphagia and incidence of pneumonia．②We could not determine a consistent relationship between the view from the laryngoscopy (the remaining jelly，salivous collection in the pyriform fossa，salivous inflow into the larynx)，the view of VF (the remaining jelly， aspiration) and the grade of dysphagia and incidence of pneumonia．Laryngeal sensation was most closely related with the grade of dysphagia and the incidence of pneumonia．③It was suggested that evaluation of laryngeal sensation would be a new standard of dysphagia which can be used to predict the possibility of ingestion and risk of aspiration pneumonia．
