Defective Closure of the Laryngeal Vestibule During Deglutition

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Abstract
Patients [250] with dysphagia were studied with cineradiography of the pharyngeal stage of deglutition. In 103 a defective closure of the laryngeal vestibule was disclosed. In 58 patients the closing of the supraglottic space, i.e., the inferior portion of the laryngeal vestibule was normal while the subepiglottic space, i.e., the superior portion of the laryngeal vestibule, was defective. In 41 patients neither the supraglottic nor the subepiglottic space closed properly during the act of deglutition. In 29 of these the contrast medium reached into the trachea. Defective closure of the laryngeal vestibule could be separated into 2 principally different categories. The 1st category could be discerned as a delayed closure of the vestibule allowing contrast medium to enter. This contrast medium was later expressed back into the pharynx when the vestibule was closed. The 2nd category could be discerned as an inability to close: the vestibule remained open during the whole time lapse of swallowing. Contrast medium remained in the vestibule until it was aspirated or expelled by vigorous coughing.

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