Question
Would the term epiglottal dismotility apply to an aged patient whose swallowing of food aspirates foodbits into her lungs?
Answer
Weakness in the epiglottis can be caused by the type of physical deterioration seen in the later stages of dementia. Dismotility would be associated with such weakness as decreased tone and coordination would result in dismotility.
There are 3 levels of protection built into the swallowing process: 1. As the swallow is initiated, the epiglottis closes over the upper pharynx to prevent aspiration of food into the airway and to direct the bolus into the esophagus; 2. False vocal fold closure provides the second opportunity to prevent aspiration 3. True vocal fold closure provides the last opportunity to keep the bolus from entering the airway.
If the epiglottis does not function properly, the first level of protection is broached and the patient is at risk for aspiration if the second and third levels of protection are also broached.
Kathy Thayer received her Master of Arts in Health Services Management from Webster University and a Certificate in Gerontology and a Master of Arts in Communication Disorders from Saint Louis University. Kathy has worked for several years as a Speech-Language Pathologist and is currently employed by Rehab Works in Sparks, Maryland.
Kathy Thayer, M.A.
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