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Purpose: This study examined the effects of chin-down swallowing on laryngeal vestibule closure. It also investigated the technique's rehabilitative impact, by assessing the stability of effects across multiple trials and aftereffects in neutral swallows on cessation of the technique. Method: Duration of laryngeal vestibule closure (dLVC) was measured with videofluoroscopy in 16 healthy participants (mean = 33.2 years, 9 men). Participants swallowed 40 times: 5 head-neutral swallows (N1), then 30 chin-down swallows, followed by 5 head-neutral swallows (N2). The first 5 chin-down swallows were categorized as early posture swallows (P1) and the last 5 as late posture swallows (P2). Within-participant comparisons determined the effects of the maneuver on dLVC during and after execution. Results: The study found that dLVC increased during chin-down swallows (N1 to P1, p = .018). This increase remained stable throughout 30 repetitions (p1 to P2, p = .994). On return to neutral, dLVC returned to baseline (N1 to N2, p = .875). Conclusions: This study demonstrated increased dLVC during chin-down swallowing, offering a possible mechanism responsible for previously reported reduced aspiration during the technique. As aftereffects were not evident after multiple chin-down swallows, the maneuver appears to offer more compensatory benefit than rehabilitative value for patients with dysphagia. Key Words: dysphagia, physiology, response to intervention, stroke, swallowing, The chin-down posture is widely used to reduce aspiration and has been shown to be effective in various dysphagia populations (Ekberg, 1986; Lewin, Hebert, Putnam, & DuBrow, 2001; Logemann et [...]

* BACKGROUND In the medical intensive care unit at the University of Virginia Health System, capnography is used to detect end-tidal carbon dioxide to protect patients from inadvertent airway cannulation [...]

Dentists should do whatever they can to keep their patients from aspirating dental material during dental treatments. One of two case reports illustrates that many dental filling materials do not show up on a chest X-ray. Of four dental materials examined by X-ray, only those made of polysulfide showed up clearly. Dentists should use a rubber dam whenever possible. They can also insert a piece of gauze and tell patients not to swallow objects that fall onto their tongue. Floss can also be used to tie material to a tooth.

Author(s): Jocelyn Grunwell [sup.1] Author Affiliations: (1) grid.428158.2, 0000000403716071, Children's Healthcare of Atlanta at Egleston-Emory University School of Medicine, , Atlanta, GA, USA Dear Editor, I read with interest the [...]