Sensibilidade oral, faríngea e laríngea em indivíduos com a doença pulmonar obstrutiva crônica

• Autor(a) principal: Rosa, Fernanda Borowsky da
• Data de Publicação: 2019
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Manancial - Repositório Digital da UFSM
• dARK ID: ark:/26339/0013000010kzz
• Texto Completo: http://repositorio.ufsm.br/handle/1/20607
• topic: DPOC (Doença Pulmonar Obstrutiva Crônica); Cavidade oral; Faringe; Laringe; Sensação; Métodos; COPD (Chronic Obstructive Pulmonary Disease); Oral cavity; Pharynx; Larynx; Sensation; Methods; CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA

Individuals with Chronic Obstructive Pulmonary Disease (COPD) use inhaled medication to control the symptoms of the disease and prevent episodes of exacerbation. In addition to this, they are frequently affected by comorbidities such as Gastroesophageal Reflux Disease (GERD). Both the use of inhaled medication such as GERD can compromise oral cavity, pharyngeal and laryngeal sensation, however little has been studied on the subject. Sensation impairment may negatively influence the safety and efficacy of swallowing. Objective: to describe and relate the findings of clinical and endoscopic assessment of oral, pharyngeal and laryngeal sensation among healthy and COPD subjects. Methods: We evaluated 27 individuals with COPD (% FEV1 / FVC 55.42 ± 9.77 and mean %FEV1 47.02 ± 17.75), 18 men (66.67%), with a mean age of 66.56 ± 8.68 years; and 11 individuals as control group (% FEV1 / FVC 79.45 ± 5.15), 5 males (45.45%), with a mean age of 60.09 ± 11.57 years. All subjects were submitted to an interview, oral and oropharyngeal sensation clinical assessment and pharyngeal and laryngeal sensation assessment through endoscopy. The Reflux Finding Score protocol was used to identify signs of laryngopharyngeal reflux. A descriptive analysis of the data was initially performed. In the analysis of nominal variables, Fisher's exact test and Chi-square test were used. For scalar variables, the normality of the data was initially verified by the Shapiro Wilk test, using the independent t-test for normal data, or in the case of non-normal data the Mann-Whitney test was used. To analyze the agreement between the evaluators of the endoscopic sensory evaluation image analysis, the Kappa test was applied. Differences were considered significant when the results presented p-values <0.05. Results: a significant association was found when comparing the COPD and control groups, regarding the use of inhaled medication (p <0.001), xerostomia complaint (p = 0.003) and thermal sensation impairment in the oral cavity (p = 0.009) and laryngeal sensation (p = 0.047). There was also a relationship between worsening of taste sensation and age (p = 0.018) in COPD patients. The findings also showed a significant relationship between oropharyngeal sensation impairment and the presence of salivary stasis in pyriform recess (p = 0.012) and pharyngeal recess (p = 0.018). Conclusion: Individuals with COPD presented compromised thermal sensation in the oral cavity, as well as in laryngeal sensation when compared to controls. The presence of stasis in pyriform and pharyngeal recess is related to impairment in oropharyngeal sensation. The degree of COPD, the smoking load and the presence of signs of laryngopharyngeal reflux did not influence the impairment of oral, pharyngeal and laryngeal sensation in the studied population. It is suggested that future research on sensation in COPD be performed in a larger group of individuals, in order to be able to separate the different variables that may influence the oral, pharyngeal and laryngeal sensation of this population (use inhalation medication, GERD), and that objective sensory tests are used.