What is the Difference Between Supraglottic and Super Supraglottic Swallow?

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The supraglottic swallow and the super-supraglottic swallow are maneuvers used to help patients with dysphagia or swallowing difficulties. They both involve voluntary closure of the vocal folds prior to the swallow, but there are differences in the level of effort and airway closure.

Supraglottic Swallow:

  1. Take a deep breath and hold it.
  2. Put a small bite of food or a sip of liquid into your mouth.
  3. Swallow (keep holding your breath).
  4. Cough right after you swallow.
  5. Swallow again.
  6. Breathe.

Super-Supraglottic Swallow:

  1. Take a deep breath and hold it tight (bear down).
  2. Put a small bite of food or a sip of liquid into your mouth.
  3. Swallow hard (keep holding your breath and bearing down).
  4. Cough right after you swallow.
  5. Swallow again.
  6. Breathe.

The main difference between the two is that the super-supraglottic swallow requires increased effort during the breath-hold before the swallow, which results in a more complete closure of the laryngeal valve. This maneuver is used for patients with reduced airway closure, while the supraglottic swallow is used for patients who demonstrate reduced airway protection during swallowing. Both methods help close off the windpipe (airway) to prevent food or liquid from going into the lungs.

Comparative Table: Supraglottic vs Super Supraglottic Swallow

The supraglottic and super supraglottic swallow methods are used to help people with swallowing disorders, such as dysphagia, swallow food and liquids more safely. Here is a table summarizing the differences between the two methods:

Feature Supraglottic Swallow Super Supraglottic Swallow
Purpose Reduces the entry of food into the airways Provides airway protection at the level of the laryngeal inlet
Technique Involves coughing right at the end of a swallow Involves an effortful breath hold before a swallow
Instructions "Take a deep breath and hold your breath, then swallow. Cough after swallowing." "Inhale and hold your breath very tightly, bearing down. Keep holding your breath and bearing down as you swallow. Cough when you are finished."
Physiological Effects Earlier onset of UES relaxation, peak value of UES contraction is lower, bolus transit time is prolonged Earlier tongue base movement, higher hyoid position at swallow onset, increased hyoid movement, longer bolus transit time, tongue base and pharyngeal wall contact, and airway protection

Both methods aim to improve airway closure and prevent aspiration, but the super supraglottic swallow provides a higher level of airway protection and involves more effort compared to the supraglottic swallow.