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Related Experiment Videos

Airway protection: evaluation with videofluoroscopy.

Katherine A Kendall1, Rebecca J Leonard, Susan McKenzie

  • 1Department of Otolaryngology, Head and Neck Surgery, University of California, Davis, Sacramento, California 95817, USA. katherine.kendall@ucdmc.ucdavis.edu

Dysphagia
|September 24, 2004
PubMed
Summary

Supraglottic closure, protecting the airway during swallowing, is typically timed before bolus arrival at the upper esophageal sphincter. This timing is not delayed in elderly individuals without dysphagia.

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Area of Science:

  • Otolaryngology
  • Swallowing Physiology
  • Gerontology

Background:

  • The airway is protected during swallowing by the elevation and approximation of arytenoid cartilages to the epiglottis, closing the supraglottic larynx.
  • Delayed or incomplete closure can lead to aspiration, a risk factor for pneumonia in patients with dysphagia (difficulty swallowing).

Purpose of the Study:

  • To evaluate the timing of supraglottic closure relative to bolus arrival at the upper esophageal sphincter in young and elderly adults without dysphagia.
  • To establish normative data for supraglottic closure timing to identify potential delays in dysphagia patients.

Main Methods:

  • Videofluoroscopic swallowing studies were conducted in the lateral view.
  • Timing of supraglottic closure and bolus transit to the upper esophageal sphincter was measured in 0.01-second intervals for two liquid bolus sizes in 60 young and 63 elderly control subjects.

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Main Results:

  • In most subjects, supraglottic closure occurred before bolus arrival at the upper esophageal sphincter.
  • A small percentage of individuals in both age groups showed closure slightly after bolus arrival (≤0.1 s delay).
  • No significant difference in closure timing was observed between the young and elderly control groups.

Conclusions:

  • The study provides objective timing data for healthy supraglottic laryngeal closure during swallowing.
  • Findings suggest that age alone does not cause a delay in this protective mechanism in individuals without dysphagia.
  • This data is crucial for identifying and managing delayed supraglottic closure in patients presenting with dysphagia.