Clinical guidance for the use of nasogastric tube feeding under restraint in eating disorders care: a systematic scoping review.

Somatosensory feedback from the larynx plays a central role in airway protection, phonatory stability, regulation of vocal effort and fatigue, and rapid compensation to perturbation [, , , , , , , ]. Despite its importance, methods for quantifying laryngeal somatosensory function remain limited. Current approaches, including air puffs [, , ], and aesthesiometers [, , ] delivered through a channeled laryngoscope, provide relatively coarse and variably delivered stimuli [, , ]. These limitations constrain testing of sensory thresholds, discrimination acuity, and reflexive motor responses with sufficient precision to study laryngeal sensorimotor control. Sensory threshold testing provides information about both conscious sensory detection and reflexive laryngeal motor responses. Discrimination testing assesses the ability to detect differences in stimulus intensity and reflects the resolution of afferent laryngeal feedback. Perturbation paradigms examine how the laryngeal motor system responds and adapts to brief, unexpected somatosensory input during phonation. Alterations in these domains have been implicated in disorders such as primary muscle tension dysphonia [], Parkinson's disease [, ], irritable larynx syndrome [], and chronic refractory cough [, ]. However, existing tools lack the precision and reproducibility needed to clearly define sensorimotor abnormalities in these disorders. Blue diode laser stimulation provides a more controlled approach to direct laryngeal stimulation. Targeted stimulation of the arytenoid region evokes laryngeal airway protection reflexes (e.g., brief and ballistic vocal fold adduction) [, ], which can be used to probe laryngeal somatosensory responses and sensorimotor function. Stimulation with the blue light laser likely produces a localized photothermal mucosal stimulus capable of activating superior laryngeal afferents and evoking protected laryngeal motor responses. Because the stimulus is delivered as localized thermal energy, it may preferentially activate superficial thermo‐ or nociceptive afferents, although contributions from polymodal or mechanosensitive afferents cannot be excluded. Output can be adjusted through wattage and pulse duration, allowing delivery of finely graded, subablative thermal stimuli spanning subthreshold to suprathreshold levels. Unlike contact‐based methods (e.g., aesthesiometers), laser stimulation reduces variability related to force application, mucosal deformation, and angle of instrumentation.