Abstract
Peripheral neural regulation of the laryngopharynx involves a complex sequence the laryngopharyngeal sensitivity receptors, triggering conscious or reflexive perception through the peripheral course of the vagus nerve. Laryngopharyngeal sensitivity receptors include the nociceptor bronchopulmonary C-fibers, mechanoreceptor (Widdicombe) cough receptors, transient receptor/ion channel potential vanilloid (TRPV), rapidly and slowly adapting receptors (RAR and SAR, respectively).The latter involves nuances of the right and left recurrent laryngeal nerves, in addition to the superior laryngeal nerves.
Proposed mechanisms of laryngopharyngeal hypersensitivity include 1) chronic vagal neuropathy, 2) virally induced neural injury (antigen exposure or viral inflammation induces neuropeptide production by mechanosensitive neurons), 3) acidification of sensory nerves during repeated reflux events, and 4) pepsin-induced proliferation of laryngeal epithelium. The challenges in diagnosing these scenarios are discussed.
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Hudson, C., Altman, K.W. (2020). Peripheral Neural Regulation of the Laryngopharynx. In: Zalvan, C.H. (eds) Laryngopharyngeal and Gastroesophageal Reflux. Springer, Cham. https://doi.org/10.1007/978-3-030-48890-1_6
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