The Function of the Epiglottis in Deglutition and Phonation

Walton, Geo. L.

doi:10.1113/jphysiol.1878.sp000025

Cited by 5 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The epiglottis acts passively as a hinged lid that can be moved over the entrance of the larynx to protect the lower airway against aspiration of liquids and solids during swallowing. Although it has been described as a key primary valve for airway protection during swallowing, several human case studies (Leder ) and experimental studies in dogs, cats, and other animals (Walton , Medda et al . ) have shown that it is not essential, as protection is also provided by closure of the glottis, the extreme sensitivity of the laryngeal mucosa, cessation of respiration during deglutition, and the ability of the base of the tongue to replace the epiglottis, the aditus laryngis being pulled up under the tongue and firmly pressed against it.…”

Section: Discussionmentioning

confidence: 99%

Intraoral diode laser epiglottectomy for treatment of epiglottis chondrosarcoma in a dog

Lorenzi¹,

Bertoncello²,

Dentini

2015

J of Small Animal Practice

View full text Add to dashboard Cite

Laryngeal tumours are rare in dogs. Surgery is the treatment of choice, but it is usually palliative in malignant conditions, due to advanced stage of the tumour at the time of diagnosis. In veterinary medicine, little information is available about the use of diode laser in laryngeal oncological surgery. In the case reported here, a dog with an epiglottic chondrosarcoma was successfully treated with diode laser epiglottectomy. The surgical technique and follow up are described.

show abstract

Section: Discussionmentioning

confidence: 99%

Intraoral diode laser epiglottectomy for treatment of epiglottis chondrosarcoma in a dog

Lorenzi¹,

Bertoncello²,

Dentini

2015

J of Small Animal Practice

View full text Add to dashboard Cite

show abstract

“…Their elucidations of the anatomy, physiology, and biological purposes of the role of the epiglottis in deglutition have proven to be correct. Although their work has been lost to the current generation of scientists, Walton 1 and Howes 2 provide both historical perspective and valuable insight. Most importantly, their results have passed the true measure of scientific discovery: "the test of time.…”

Section: Discussionmentioning

confidence: 99%

“…Since the 19th century, the epiglottis, being the most prominent structure in the pharynx, has been the subject of scientific inquiry. Although some scientists have regarded the adult human epiglottis as vestigial, with no important physiological swallowing function, [1][2][3][4][5][6] others have felt that it plays a key role in preventing deglutitive aspiration. [7][8][9][10][11] And so the controversy continues.…”

Section: Introductionmentioning

confidence: 99%

“…Whereas both historical and contemporary research has reported that successful deglutition can occur when the epiglottis is impaired or even destroyed by either disease or surgery, 1,2,5,6,12 others have contended that the epiglottis is important for airway protection during deglutition, by providing a protective valvelike action during swallowing, 7 or that specific movement patterns [8][9][10] or positions 11 are indicative of aspiration risk. However, the exact physiological mechanisms that cause epiglottic downfolding have only been partially explained.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Epiglottis is Not Essential for Successful Swallowing in Humans

Leder¹,

Burrell²,

Daele³

2010

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

Controversy has continued for well over 100 years regarding the role of the epiglottis in deglutition. We describe the effect of isolated epiglottectomy on swallowing success in a case series of 3 adult human subjects with isolated epiglottectomy due to trauma, surgery, or cancerous erosion. The patients were 42, 51, and 70 years of age, and swallowing was analyzed objectively with videofluoroscopy. All subjects exhibited successful swallowing with all food types: thin liquid, puree, and solid food. Specifically, the patient with traumatic epiglottectomy exhibited rapid swallowing success, the patient with surgical epiglottectomy exhibited a short period of dysphagia due to postoperative edema, followed by swallowing success, and the patient with epiglottectomy due to cancerous erosion of the entire epiglottis exhibited long-term adaptation, with successful swallowing maintained. We conclude that the epiglottis is not essential for successful swallowing in humans, because individuals can readily adapt to isolated epiglottectomy and avoid tracheal aspiration.

show abstract

“…We became interested in treating the obstructive nature of the dysfunctional epiglottis and began performing partial epiglottidectomies in an effort to improve swallow efficiency in this otherwise recalcitrant dysphagia condition. Given the long, controversial history in the literature regarding the role of the epiglottis in a normal functional swallow, we performed a retrospective review of an initial series of patients who underwent partial epiglottidectomy as part of their dysphagia management . The purpose of this report was to describe our preliminary experience and results in a small group of patients.…”

Section: Introductionmentioning

confidence: 99%

Transoral partial epiglottidectomy to treat dysphagia in post‐treatment head and neck cancer patients: A preliminary report

2013

View full text Add to dashboard Cite

Objectives To determine symptoms and findings in patients with dysphagia related to epiglottic dysfunction. To analyze outcomes in patients who underwent partial epiglottidectomy due to dysphagia related to epiglottic dysfunction Study Design Review and analysis of clinical data obtained as part of the diagnosis and treatment of patients with dysphagia related to epiglottic dysfunction. Methods A retrospective review was performed of all post-treatment head and neck cancer patients who underwent epiglottidectomy at a single tertiary care referral center. Objective pre- and post-procedure swallow findings, endoscopic evaluation, and subjective improvement based on patient self-report were reviewed. Results Seven patients were identified based on endoscopic evaluation and modified barium swallow study (MBSS) as having epiglottic pathology leading to dysphagia. Specific anatomic and functional findings included thickening of the epiglottis, absence of epiglottic deflection, vallecular bolus retention during and after the swallow, and bolus backflow from the pharynx to the oral or nasal cavity. Partial epiglottidectomy was performed in these patients. Post-operative MBSS was analyzed for changes in swallow efficiency and safety. Nearly all patients demonstrated improved pharyngeal bolus passage with little to no added swallowing morbidity. Conclusions Preliminary findings suggest a role for partial epiglottidectomy in post-treatment head and neck cancer patients with swallowing disorders. Ideal candidates have intact tongue base contraction and poor retroflexion of the epiglottis, which result in bolus obstruction at the level of the valleculae. Partial epiglottic resection enables improved bolus passage in the pharyngeal phase. Minimal post-operative morbidity occurs in the appropriately selected patient.

show abstract

The Function of the Epiglottis in Deglutition and Phonation

Cited by 5 publications

References 0 publications

Intraoral diode laser epiglottectomy for treatment of epiglottis chondrosarcoma in a dog

Intraoral diode laser epiglottectomy for treatment of epiglottis chondrosarcoma in a dog

Epiglottis is Not Essential for Successful Swallowing in Humans

Transoral partial epiglottidectomy to treat dysphagia in post‐treatment head and neck cancer patients: A preliminary report

Contact Info

Product

Resources

About