Author(s)
Joseph Kidane BS
Grant Gochman MS
W. John Boscardin PhD
Clark A. Rosen MD
VyVy N. Young MD
Yue Ma MD
Affiliation(s)
University of California San Francisco, Department of Otolaryngology-Head and Neck Surgery, San Francisco, CA University of California San Francisco, Department of Epidemiology & Biostatistics, San Francisco, CA ;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to describe the effect of aesthesiometer size, saliva, successive compressions, and angles of tissue contact on stimulus force delivered when evaluating laryngopharyngeal sensation.
Objectives: Cheung-Bearelly aesthesiometers have been used to deliver stimuli to the laryngopharynx and objectively evaluate sensation. Ambiguity surrounds the transformation of tactile force in the laryngopharyngeal environment. This study aims to evaluate the effect of aesthesiometer size, saliva, successive compressions, and angles of tissue contact on stimulus force delivered.
Study Design: Ex vivo study using cadaveric buccal mucosa model.
Methods: An ex vivo stimulus delivery device was constructed to directly measure tactile force of aesthesiometers in different environments. Dry and saliva-saturated aesthesiometers (6-0, 5-0, 4.5-0, and 4-0) were each compressed six times on a 2x4 cm section of cadaveric buccal mucosa zeroed on an electronic balance (0.0001 g readability). The force for each compression was recorded at 0, 15, 30, 45, 60-degrees from the vertical plane. 240 total compressions were analyzed utilizing a mixed-effects statistical model.
Results: Increasing aesthesiometer size positively correlated with tactile force. The mean force in grams (g) delivered for the 6-0, 5-0, 4.5-0, and 4-0 aesthesiometers were 0.017, 0.082, 0.120, and 0.268 g respectively (p<0.001). Mean force was significantly reduced at a 60-degree angle of contact (0.049 g decrease, p=0.002). Specifically, 4-0 aesthesiometer was reduced at 30 degrees (0.081 g decrease, p=0.003). Tactile force decreased with successive compressions (0.004 g decrease/compression, p<0.001). The effect of saliva was insignificant (p=0.83).
Conclusions: Investigators found that up to 45-degrees (15-degrees for 4-0 aesthesiometer) deviation from orthogonal tissue contact and salivary forces do not significantly alter tactile stimuli delivered by aesthesiometers. Repeated compressions of aesthesiometers decrease force delivered, but this is insignificant in the setting of a finite testing protocol for laryngopharyngeal sensory testing.