The Occurrence of Laryngeal Penetration and Aspiration in Patients with Glottal Closure Insufficiency

Glottal closure during the pharyngeal phase of swallowing is one of the important steps in protecting the airway. Generally, it is believed that any deficiency in this process can lead to laryngeal penetration and aspiration. This study investigated the incidence of laryngeal penetration and aspiration among 44 patients with glottal closure insufficiencies that were referred for voice and swallowing evaluation to our institution. The videostroboscopy and 3 oz water swallow test were performed for all of the patients and dysphagic patients were screened and referred for videofluoroscopy. Overall, 15.90% of patients demonstrated signs of laryngeal penetration (13.63%) and aspiration (2.27%). The patients with the pattern of incomplete closure illustrated the highest percentage of penetration-aspiration (21.73%, 4.34%) among other GCI patterns. Thus, early interventions for these patients' swallowing condition seem necessary.

[1]  Steven B. Leder,et al.  Clinical Utility of the 3-ounce Water Swallow Test , 2008, Dysphagia.

[2]  P. Harrison,et al.  Swallowing dysfunction in patients with unilateral vocal fold paralysis: aetiology and outcomes , 2005, The Journal of Laryngology & Otology.

[3]  P. Clavé,et al.  Approaching oropharyngeal dysphagia. , 2004, Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva.

[4]  平野 実,et al.  Understanding Voice Problems: A Physiological Perspective for Diagnosis and Treatment , 1996 .

[5]  Ali Barikroo,et al.  Comparing the Effects of Rehabilitation Swallowing Therapy vs. Functional Neuromuscular Electrical Stimulation Therapy in an Encephalitis Patient: A Case Study , 2011, Dysphagia.

[6]  A. Verdaguer,et al.  Disfagia orofaríngea en el anciano , 2005 .

[7]  J. Searl,et al.  Electroglottographic and Acoustic Changes following Type Ithyroplasty or Autologous Fat Injection , 2001, The Annals of otology, rhinology, and laryngology.

[8]  M. Andrews.  Manual of voice treatment , 1995 .

[9]  J. Koufman,et al.  Muscle Tension Dysphonia as a Sign of Underlying Glottal Insufficiency , 2002, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[10]  CCC-SLP Steven B. Leder PhD,et al.  Incidence of Vocal Fold Immobility in Patients with Dysphagia , 2005, Dysphagia.

[11]  I. Chen,et al.  The role of glottal gap in predicting aspiration in patients with unilateral vocal paralysis. , 2004, Clinical otolaryngology and allied sciences.

[12]  P. Murthy,et al.  Unilateral Vocal Cord Palsy: An Etiopathological Study , 2011 .

[13]  W J Hogan,et al.  Coordination of deglutitive glottic closure with oropharyngeal swallowing. , 1990, Gastroenterology.

[14]  G. Berke,et al.  Advances in the management of glottic insufficiency , 2003, Current opinion in otolaryngology & head and neck surgery.

[15]  B. Jones,et al.  Prevalence of Aspiration and Laryngeal Penetration in Patients with Unilateral Vocal Fold Motion Impairment , 2014, Dysphagia.

[16]  P J Kahrilas,et al.  Closure mechanisms of laryngeal vestibule during swallow. , 1992, The American journal of physiology.

[17]  P. Flint,et al.  Pathophysiology and Indications for Medialization Thyroplasty in Patients with Dysphagia and Aspiration , 1997, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[18]  T. Murry,et al.  Flexible Endoscopic Evaluation of Swallowing With Sensory Testing in Patients With Unilateral Vocal Fold Immobility: Incidence and Pathophysiology of Aspiration , 2005, The Laryngoscope.

[19]  V. Arreola,et al.  [Oral-pharyngeal dysphagia in the elderly]. , 2005, Medicina clinica.

[20]  Ellen B. Roecker,et al.  A penetration-aspiration scale , 2004, Dysphagia.