A maneuver in which, just before swallowing, a person drops the chin to or toward the chest. This maneuver has the effect of narrowing the pharynx so that the propulsive forces of swallowing have a smaller passageway in which to work, which can help to counteract some individuals’ tendency toward hypopharyngeal pooling, laryngeal penetration, or even aspiration. The chin tuck maneuver can be “tested” for its efficacy during both the videoendoscopic swallowing study and videofluoroscopic swallowing study, in order to determine whether this maneuver should become a formal part of the patient’s swallowing strategy.
VESS Demonstrating Presbyphagia, Chin Tuck Maneuver, Hypopharyngeal Pooling, Laryngeal Penetration and Effective Cough
VESS (1 of 5)
The patient swallowed a bolus of blue-stained applesauce to verify basic (though abnormal) capability. This photo follows 4 additional boluses delivered in a rapid, pressured fashion, intentionally seeking the patient’s “limits.” Note pooled blue applesauce, but without soiling of the laryngeal vestibule.
Chin tuck maneuver (2 of 5)
Moments later, the patient was asked to swallow again, but with chin tucked down towards chest. Note how effective this maneuver was in clearing away the residual material seen in the prior photo.
Aspiration (3 of 5)
Due to its lower viscosity, blue-stained water flows more quickly than applesauce, and enters the laryngeal vestibule. Fortunately, the patient is closing the vocal cords simultaneously, so that aspiration does not occur.
Laryngeal penetration (4 of 5)
Just after the swallow is completed, one can see a trace of blue-stained water just above the not-yet-opened cords. This is technically penetration, and not aspiration.
Air is blasted out of vestibule (5 of 5)
Using “stored” pulmonary air, this trace of penetrated water is “blasted” up and out of the laryngeal vestibule, and is never aspirated.”
