Airway protection: evaluation with videofluoroscopy

Dysphagia
Katherine A KendallSusan McKenzie

Abstract

During videofluoroscopic swallowing studies performed in the lateral view, the arytenoid cartilages are seen to elevate and approximate the down-folding epiglottis, effectively closing the supraglottic larynx and protecting the airway. This mechanism may be incomplete or delayed in patients complaining of dysphagia and may lead to "penetration" of bolus material into the airway. This study evaluates the timing of supraglottic closure relative to the arrival of the bolus at the upper esophageal sphincter in 60 young control subjects and in 63 elderly control subjects without dysphagia. Event timing was measured in 0.01-s intervals from videofluoroscopic studies for two liquid bolus size categories. Results of the analysis revealed that, in most individuals, the arytenoid cartilages approximate the epiglottis prior to the arrival of the bolus at the upper esophageal sphincter. However, in both bolus size categories, there were individuals who achieved complete supraglottic closure after the bolus had arrived at the sphincter, but never greater than 0.1 s later. No delay in the timing of supraglottic closure relative to bolus arrival at the sphincter was found in the elderly subject group compared with the young subject group. The...Continue Reading

Citations

Aug 10, 2006·Dysphagia·Rebecca Leonard, Susan McKenzie
Sep 29, 2009·Dysphagia·Atsuko Kurosu, Jeri A Logemann
Jan 7, 2014·Dysphagia·Sonja M MolfenterCatriona M Steele
May 16, 2006·Thoracic Surgery Clinics·B Zane Atkins, Thomas A D'Amico
Jul 6, 2014·European Journal of Oncology Nursing : the Official Journal of European Oncology Nursing Society·Liping ZhangZhiquan Huang
Nov 26, 2015·The Annals of Otology, Rhinology, and Laryngology·Julia K EllerstonKatherine A Kendall
Aug 10, 2005·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Bonnie Martin-HarrisDonald O Castell
Oct 2, 2007·Journal of Speech, Language, and Hearing Research : JSLHR·Dorie A Mendell, Jeri A Logemann
Aug 21, 2018·Journal of Oral Rehabilitation·Kannit PongpipatpaiboonMarlís G Fernández
Jan 23, 2019·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Katherine A Kendall
May 14, 2021·The Anatomical Record : Advances in Integrative Anatomy and Evolutionary Biology·Maria Ines R Gonçalves, Henrique M Lederman

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