The role of laryngeal hypersensitivity in dysphagia: A scoping review with embedded stakeholder involvement.

What is already known on the subject Swallowing difficulties can occur in adults for a number of different reasons, such as neurological, respiratory or physiological conditions. Swallowing difficulties with no evidence of biomechanical or structural impairment on instrumental assessment and of unknown cause (termed idiopathic functional dysphagia or medically unexplained dysphagia) is a poorly understood phenomenon. More recently, concurrent oropharyngeal dysphagia and laryngeal hypersensitivity and/or muscle tension have been posited as a potential underlying mechanism. What this study adds to the existing knowledge This scoping review contributes to our expanding knowledge of the role of laryngeal hypersensitivity in dysphagia by providing an overview of the current evidence related to the terminology and assessment tools reported in the literature. Embedded patient and stakeholder involvement further deepens real-world insights into the increased referrals for these individuals with increasing uncertainty in how to best assess, manage and support patients. Patients equally have reported that reduced professional awareness and inequalities in service delivery pathways result in poor patient experience and quality of life, and healthcare economic burden. What are the potential or actual clinical implications of this work? This scoping review draws our attention to an area of practice which has received little attention in both clinical practice and academic research. First, the study raises awareness of this population and the impact for services, speech and language therapists and clinicians; and second, highlights evidence-practice gaps with seldom consistency in the use of terminology and assessment approaches. The study provides priority research themes to expand our knowledge and understanding, as guided by the literature and patient and stakeholder input.