Laryngeal Sensation Before and After Clearing Behaviors

Abstract

People frequently present to voice clinics with complaints of irritating laryngeal sensations. Clinicians attempt to reduce the irritating sensations and their common sequela, coughing and throat clearing, by advocating techniques that remove the irritation with less harm to the vocal fold tissue. Despite the prevalence of patients with these complaints, it is not known if the less harmful techniques recommended by clinicians are effective at clearing irritating laryngeal sensations or that irritating laryngeal sensations are, in fact, more frequent in people with voice disorders than people without voice disorders. Assessments of participant-reported laryngeal sensation, pre- and post-clearing task, were obtained from 22people with and 24 people without a voice disorder. Six clearing tasks were used to preliminarily evaluate the differing effects of tasks believed to be deleterious and ameliorative. People with and without voice disorders reported pre-clear laryngeal sensation at a similar rate. Post-clear sensation was less likely to be completely or partially removed in people with voice disorders than in the nonvoice-disordered group. Hard throat clear and swallow with water were the most effective techniques in removing laryngeal sensation. The findings provide initial evidence for some of the clinical practices common to treating patients with voice disorders and chronic clearing, such as advocating for swallowing a sip of water, as a replacement behavior instead of coughing or throat clearing. However, the findings raise questions about other practices such as associating irritating laryngeal sensation with a voice disorder.