{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T14:53:52Z","timestamp":1777215232617,"version":"3.51.4"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives\/Hypothesis<\/jats:title>\n                    <jats:p>To develop a method for threshold estimation of the laryngeal adductor reflex (LAR) response using Cheung\u2010Bearelly monofilaments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010two healthy adults (12 men, 10 women) were tested for LAR response outcome using 30\u2009mm 5\u20130 and 4\u20130 nylon monofilaments. Tactile stimuli were delivered to the aryepiglottic (AE) fold and medial pyriform sinus (MPS). Dichotomous classifier features and performance (area under the curve (AUC)), the LAR response outcome agreement and disagreement matrix, and test\u2013retest reliability were examined. From those data, a test protocol that would minimize patient burden to estimate the LAR triggering threshold was formulated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Classifier performance of 5\u20130 monofilament stimulation of the AE fold (sensitivity\u00a0=\u00a00.63, specificity\u00a0=\u00a00.63, PPV\u00a0=\u00a00.74, NPV\u00a0=\u00a00.25) and MPS (sensitivity\u00a0=\u00a00.45, specificity\u00a0=\u00a00.77, PPV\u00a0=\u00a00.74, NPV\u00a0=\u00a00.23,) was slightly below that of 4\u20130 monofilament stimulation of the AE fold (sensitivity\u00a0=\u00a00.82, specificity\u00a0=\u00a00.50, PPV\u00a0=\u00a00.82, NPV\u00a0=\u00a00.50) and MPS (sensitivity =\u00a00.84, specificity\u00a0=\u00a00.64, PPV\u00a0=\u00a00.90, NPV\u00a0=\u00a00.56), based on AUC. LAR response outcome agreement for 5\u20130 and 4\u20130 stimulations was high (93%) for 5\u20130 positive response, but low (29%) for 5\u20130 negative response. Aesthesiometer test\u2013retest reliability for LAR response outcome was excellent (Cronbach's alpha\u00a0=\u00a00.97).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Threshold estimation of the LAR response may be operationalized by adopting a decision tree protocol. For negative LAR response to initial 5\u20130 monofilament stimulation and positive response to subsequent 4\u20130 monofilament stimulation, the higher threshold is confirmed. Positive LAR response to 5\u20130 or 4\u20130 monofilament stimulation is expected in over 90% of asymptomatic adults. Negative LAR response to 4\u20130 monofilament stimulation identifies patients at risk for laryngopharyngeal hyposensitivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      3b\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 132:163\u2013168, 2022\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.29761","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T07:21:50Z","timestamp":1626765710000},"page":"163-168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["<scp>Aesthesiometer\u2010Based<\/scp>\n                    Testing for Laryngopharyngeal Hyposensitivity"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7545-5654","authenticated-orcid":false,"given":"Madeleine P.","family":"Strohl","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, San Francisco  San Francisco California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1687-8240","authenticated-orcid":false,"given":"Abel P.","family":"David","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, San Francisco  San Francisco California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D.","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, San Francisco  San Francisco California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-1086","authenticated-orcid":false,"given":"Clark A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, San Francisco  San Francisco California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3095-8290","authenticated-orcid":false,"given":"VyVy N.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, San Francisco  San Francisco California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0778-1044","authenticated-orcid":false,"given":"Jolie L.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, San Francisco  San Francisco California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1724-4944","authenticated-orcid":false,"given":"Steven W.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, San Francisco  San Francisco California 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