Dysphagia, Dysphonia and Laryngeal Hypersensitivity following Whiplash

Abstract

Non-specific self-reports of dysphagia and dysphonia have been reported by people with whiplash associated disorder (WAD) following motor vehicle collision (MVC). Despite this, the degree and nature of these problems, their possible functional and psychological consequences, and potential mechanistic drivers remain poorly understood. The aim of this thesis was to investigate the degree and nature of dysphagia, dysphonia and laryngeal sensory symptoms following whiplash, their impact on wellbeing and participation, and explore potential mechanisms.

This thesis comprises 4 studies which involved: i) a scoping review, ii) a case series, iii) a secondary analysis of patient-reported outcomes and measurements of pharyngeal volume from a large cohort, and iv) thematic analysis of interview data. The thesis achieved the aim of demonstrating dysphagia, dysphonia and laryngeal hypersensitivity exist after whiplash as previously under-recognised features of WAD. Findings have provided insight into the nature of these problems, their far-reaching impact, and the barriers which exist to identify and manage them. Although mechanisms are still unknown, some findings from this thesis suggest that problems may be more likely to occur in those with poor recovery and high levels of co-morbid disability. However, much more systematic research is needed to explore that theory. Findings from the work in this thesis have also highlighted the need to educate healthcare professionals about these potential consequences of whiplash, establish methods that will help identify those at risk for dysphagia and dysphonia, and to conduct further mechanistic inquiry into the underlying factors contributing to these problems.