Abstract
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.
Highlights
While swallowing is one of the most critical requirements of every human, the affected swallow could be the source of pain, nutritional incompetency, and loss of health [1]
The present study is the first report on the overall incidence of laryngeal penetration and aspiration in patients with different patterns of glottal closure insufficiency (GCI) which was based on referral to our medical institution
The incidence of penetration and aspiration in our samples was 15.90% (13.63% for penetration and 2.27% for aspiration) which is lower than other studies (24% to 61%). It is certainly because of the fact that all of the previous works have considered laryngeal penetration and aspiration events just in unilateral paralysis conditions in which the area of glottal gap in this condition is larger than other patterns
Summary
While swallowing is one of the most critical requirements of every human, the affected swallow could be the source of pain, nutritional incompetency, and loss of health [1]. Any deficiency in the safety of swallowing can lead to laryngeal penetration and aspiration, and these outcomes can result in adverse health consequences such as pneumonia and even death [2, 3]. One of the protective mechanisms in the swallowing process is glottal closure. One of the issues that can lead to incomplete airway closure during swallowing is glottal closure insufficiency (GCI). Belafsky and his colleagues defined GCI as a “form of laryngeal hypofunction during which the closed phase of phonation, which is normally 50% of the cycle of vibration, is 45% or less” [6]. With regard to the form of glottis closure, GCI can be observed in one of the six configurations: (I) anterior chink, (II) posterior chink, (III) irregular, (IV) spindle, (V) hourglass, and (VII) incomplete closure (Figure 1) [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
