Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

Introduction: The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective: This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method: Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years (SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years (SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (<= 65 years and > 65 years) within the COPD cohort. Results: We found significantly higher frequencies of reported use of inhaled medications (p <.001) and xerostomia (p=.003) in the COPD cohort. Oral cavity thermal sensation (p=.009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group (p=.018). Conclusion: This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.