Laryngeal hypersensitivity : Laryngeal pesthesia Questionnaire,...................,LHQ: Laryngeal hypersensitivity questionnaire; PVFM: Paradoxical vocal fold movement.,.....................,Laryngeal Dysfunction Syndromes include chronic refractory cough, pdoxical vocal fold movement (vocal cord dysfunction), muscle tension dysphonia and globus pharyngeus. These conditions present to clinicians as discrete syndromes based around a dominant manifestation of a disordered laryngeal adductor reflex, e.g. cough, vocal fold closure, vocalisation, or swallowing.

Abnormal sensory experience is characterised in three ways: 

(1) hypersensory–sensation triggered by stimuli that is sub-threshold for triggering that sensation, 
(2) pesthesia–altered sensory experience, and 
(3) allodynia–sensation triggered by stimuli that do not normally trigger those sensations.

Patients with laryngeal dysfunction syndromes such as chronic refractory cough, paradoxical vocal fold movement, globus pharyngeus and muscle tension dysphonia frequently report irritation and discomfort in the laryngeal region.


1.
Chronic Refractory Cough. The patients with chronic refractory cough had been referred by respiratory physicians for behavioural management of cough. The cough had persisted for longer than eight weeks and was refractory to medical treatment based on the anatomic diagnostic protocol and including asthma, gastroesophageal reflux disease, lung pathology and rhinosinusitis.

2.
Paradoxical Vocal Fold Movement. The patients with paradoxical vocal fold movement were diagnosed by either respiratory physicians or otolaryngologists. These patients had been referred for behavioural management of their respiratory symptoms which included inspiratory dyspnoea, noisy breathing and throat tightness. Asthma and other pulmonary diseases had been discounted as a reason for the respiratory problems in this group. They had positive symptoms of PVFM and a fall in FIF50 of greater than 20%.

3.
Globus Pharyngeus. The third group with globus pharyngeus were referred for clinical assessment and management of swallowing. These participants presented with globus sensation such as a sensation of an irritation, lump or tightness in the throat in the absence of oropharyngeal dysphagia.

4.

Muscle Tension Dysphonia. The fourth group included patients with muscle tension dysphonia diagnosed by otolaryngologists referred for dysphonia. These patients had a deviation in perceptual voice quality along with excessive tension in the intrinsic and/or extrinsic laryngeal muscles in the absence of any structural, neurological or significant psychological pathology.




Obstruction :
Abnormal sensation, stuck, blocked, tight, irritated, pressing throat, constriction, food catches. 

Pain/thermal :
Pain, pushing chest, hot burning. 

Irritation : 
Tickle, itch, phlegm. 



Score : 

All of the time. 1
Most of the time. 2
A good bit of the time. 3
Some of the time. 4
A little of the time. 5
Hardly any of the time. 6
None of the time. 7


1. There is an abnormal sensation in my throat. (O)
2. I feel phlegm and mucous in my throat (TT)
3. I have pain in my throat (P/Th)
4. I have a sensation of something stuck in my throat (O)
5. My throat is blocked. (O)
6. My throat feels tight. (O)
7. There is an irritation in my throat. (O)
8. I have a sensation of something pushing on my chest. (P/Th)
9. I have a sensation of something pressing on my throat (O)
10. There is a feeling of constriction as though needing to inhale a large amount of air. (O)
11. Food catches when I eat or drink. (O)
12. There is a tickle in my throat. (TT)
13. There is an itch in my throat. (TT)
14. I have a hot or burning sensation in my throat (P/Th)