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The gagging patient in ORL examinations: predictors, evaluation and treatment

  • Head & Neck
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Gagging may be a challenge in daily otorhinolaryngology (ORL) routine. This cross-sectional study aimed to examine conditions of gagging as limitation to ORL examination and the efficacy of acupressure as tool to reduce exaggerated gagging.

Methods

The study was conducted on a total of 360 study subjects. There was a survey part and a routine ORL examination with observation of gagging behaviour. Through binomial univariate logistic regression, predictors of clinically relevant exaggerated gagging were identified. Wilcoxon signed rank test was used to evaluate efficacy of acupressure point CV-24 to reduce gagging while examination.

Results

First gagging’s relevance was indicated by over 40% of study subjects showing clinically relevant exaggerated gagging. Furthermore, we found that more psychogenic than somatogenic features proved to be predictors of exaggerated gagging. Third acupressure point CV-24 showed statistical significant reduction of gagging intensity and improved examination feasibility.

Conclusion

Awareness of exaggerated gagging’s predictors are the first step to deal with gagging in daily practice. Acupressure might be an effective tool to overcome gagging in the affected patients.

Level of evidence

We suggest at least Level IV according to Oxford (UK) CEBM Levels of Evidence.

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Acknowledgements

We say thank you to Jakob Schöpe, M.Sc., Department of Medical Biometrics, Epidemiology and Medical Informatics, Saarland University Medical Centre, as consulted statistician.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Saarland, Germany

    David Zuschlag, Philipp Kulas, Bernhard Schick & Alessandro Bozzato

Authors
  1. David Zuschlag
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  2. Philipp Kulas
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  3. Bernhard Schick
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  4. Alessandro Bozzato
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Corresponding author

Correspondence to David Zuschlag.

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Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This study is based on research involving human participants. This article does not contain any studies with animals performed by any of the authors.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards (Identification number of the Institutional Review Board: 167/13).

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Informed consent was obtained from all individual participants included in the study.

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German Otorhinolaryngology Annual Meeting “Würgereiz bei Untersuchungen von Mundraum und Pharynx: strukturierte Beurteilung, Prävalenz, Ursachen und seine mögliche Supprimierbarkeit durch den Akupressurpunkt CV-24“, Phillip Kulas, David Zuschlag, Bernhard Schick, Dietmar Hecker, Alessandro Bozzato; published Mars 30th 2016 at “87. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.”, Mai 4th to 7th 2016, Düsseldorf; https://doi.org/10.3205/16hnod025, urn:nbn:de:0183-16hnod0254.

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Zuschlag, D., Kulas, P., Schick, B. et al. The gagging patient in ORL examinations: predictors, evaluation and treatment. Eur Arch Otorhinolaryngol 276, 1775–1781 (2019). https://doi.org/10.1007/s00405-019-05404-w

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  • DOI: https://doi.org/10.1007/s00405-019-05404-w

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