Recovery of Laryngeal Closure in Post-stroke Survivors

Abstract

Thirty to 70% of post-stroke survivors suffer from dysphagia [1,2]. Post-stroke survivors with dysphagia commonly show difficulties in airway protection during pharyngeal swallowing [3,4]. Airway protection during swallowing is achieved through laryngeal closure. Laryngeal closure is executed by an initial downward displacement of the epiglottis with a concurrent approximation of the arytenoids to the base of the epiglottis [5-7]. The contact between the epiglottis and arytenoid is sustained until the bolus passes the pharynx and enters the esophagus. A delayed, incomplete, and reduced laryngeal closure may lead to aspiration. Aspiration is defined as the bolus entering into the vestibule and then passing below the vocal folds [8]. Disturbances in the initiation and duration of laryngeal closure in post-stroke survivors are important physiological steps in the pharyngeal swallow [9,10]. Park and her colleagues (2010) reported that the post-stroke survivors show a reduced duration of laryngeal closure regardless of aspiration [9]. However, in regard to the initiation of laryngeal closure, post-stroke survivors with aspiration showed a delayed initiation of laObjectives: The purpose of this study was to examine whether traditional swallowing intervention improves the initiation or duration of laryngeal closure in post-stroke survivors using the initial and follow-up videofluoroscopic swallowing study (VFSS).