The study titled Does Epiglottic Deflection Contribute to Airway Protection in Patients Living With Dementia? provides critical insights for speech-language pathologists aiming to improve their practice and outcomes for patients with dementia. This research, published in the Canadian Journal of Speech-Language Pathology and Audiology, investigates the role of epiglottic deflection in protecting the airway during swallowing in dementia patients.
Understanding the mechanisms of swallowing and airway protection is essential for clinicians working with dementia patients, who are at high risk for dysphagia and aspiration pneumonia. The study retrospectively analyzed videofluoroscopic swallowing studies (VFSS) of 44 participants, aged 46-100, to assess the relationship between epiglottic deflection and airway invasion using the Modified Barium Swallow Impairment Profile and the Penetration-Aspiration Scale.
The key findings revealed no significant differences in swallow safety based on epiglottic deflection. Specifically, the study showed that incomplete epiglottic deflection did not always result in airway invasion, and complete epiglottic deflection did not always ensure airway protection. These results suggest that other defense mechanisms, such as hyolaryngeal excursion and closure of the true and false vocal folds, play a more crucial role in airway protection.
For practitioners, this means that focusing solely on epiglottic deflection may not be sufficient. Instead, a comprehensive approach that includes evaluating and enhancing hyolaryngeal excursion and other mechanisms is essential. Post hoc analyses indicated that hyoid movement was the only factor significantly influencing epiglottic deflection in this sample, highlighting the importance of targeting hyoid excursion in therapeutic interventions.
To implement these findings into practice, clinicians should consider the following strategies:
- Assess hyolaryngeal excursion and other airway protection mechanisms during VFSS.
- Incorporate exercises that target suprahyoid muscles to improve hyoid movement.
- Use a holistic approach to swallowing therapy that addresses multiple components of the swallowing mechanism.
Encouraging further research in this area is also crucial. Future studies should investigate the physiological impairments interfering with airway protection mechanisms and the kinematics related to epiglottic deflection in patients with dementia. Such research will help refine therapeutic protocols and improve outcomes for this vulnerable population.
To read the original research paper, please follow this link: Does Epiglottic Deflection Contribute to Airway Protection in Patients Living With Dementia?
