Laryngeal hypersensitivity from the perspective of pain science: An integrative review of empirical studies on associated factors and processes

Auteurs

William Saint-Jules, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada; Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Inclusion, Quebec City, Quebec, Canada
Hugo Massé-Alarie, Faculty of Medicine, Université Laval, Québec, QC, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Inclusion, Quebec City, Quebec, Canada; School of Rehabilitation Sciences, Université Laval, Quebec City, Quebec, Canada
Nicole Y. K. Li-Jessen, School of Communication Sciences and Disorders, McGill University, Montreal, Quebec, Canada; Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada; The Centre for Research on Brain, Language and Music, McGill University, Montreal, Quebec, Canada; Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada; Translational Research in Respiratory Diseases Program, Research Institute of McGill University Health Center, Montreal, Quebec, Canada
Maude Desjardins, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada; Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada; School of Rehabilitation Sciences, Université Laval, Quebec City, Quebec, Canada; The Centre for Research on Brain, Language and Music, McGill University, Montreal, Quebec, Canada

Type de document

Revues de littérature, synthèses de connaissances

Année de publication

2025

Langue

Anglais

Titre de la revue

Journal of Voice

Résumé

Objective

Laryngeal hypersensitivity (LHS) is a state of heightened sensorimotor response to stimuli in the upper airway. Although its clinical picture is becoming progressively clearer with recent research progress, specificities about its associated factors and processes remain to be clarified. The aim of this integrative review was to synthesize published empirical data from human studies on LHS, focusing on related factors and pathophysiology.

Study Design and Data Sources

Integrative review of the literature; Pubmed, EMBASE, and Web of Science.

Methods

Keywords associated with the following three main concepts were used to query databases: (1) manifestations potentially associated with an irritable larynx (dysphonia, inducible laryngeal obstruction (ILO), chronic cough, and globus); (2) hypersensitivity; and (3) pathophysiology. Peer-reviewed studies in English providing empirical original research data on the pathophysiology of LHS were included, with no restriction based on study design.

Results

In total, 54 papers met the inclusion criteria. Factors potentially associated with LHS were identified, namely (1) psychological and lifestyle factors, (2) upper airway inflammation and injuries from exogenous/endogenous irritants, infections, or mucosal atrophy, (3) sex hormones, (4) metabolic abnormalities, and (5) aberrant respiratory behavior. Given the parallels between pain-related mechanisms and suggested LHS mechanisms, processes identified as putatively contributing to LHS were categorized in light of the current pain literature. Findings suggest that LHS may stem from a peripheral tissue insult, a neuropathic insult, and/or maladaptive neuroplasticity. Gaps in the literature were identified, in part driven by an uneven repartition of research across the various alleged manifestations of LHS. In fact, a large majority of studies pertained to chronic cough, with very few addressing muscle tension dysphonia, ILO, and globus.

Conclusion

Future research can focus on the potential role of hypersensitivity in manifestations such as muscle tension dysphonia and ILO, and on the development of guidelines to identify the specific underlying factors and mechanisms at play in LHS symptoms.

Mots-clés

Douleur, Pain, Larynx, Revue de littérature, Literature review

Numéro de projet IRSST

n/a

Citation recommandée

Saint-Jules, W., Massé-Alarie, H., Li-Jessen, N. Y. K. et Desjardins, M. (2025). Laryngeal hypersensitivity from the perspective of pain science: An integrative review of empirical studies on associated factors and processes. Journal of Voice. https://doi.org/10.1016/j.jvoice.2025.03.032