Pathophysiology of aspiration and indications for medialization thyroplasty

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Abstract

Glottic closure, elevation of the larynx, anterior displacement of the arytenoids, and retroflexion of the epiglottis are normal and essential events in the swallowing mechanism. It is therefore not surprising that impaired laryngeal function resulting in incomplete glottic closure will affect not only phonatory function but also deglutition. The effects of impaired glottic function on swallowing are reviewed with respect to pathophysiology of aspiration and dysphagia. Current methods for evaluation, conservative management, and surgical treatment strategies are reviewed, with emphasis on early vocal fold medialization for symptoms of aspiration and dysphagia associated with laryngeal paralysis.

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