Along with the Mendelsohn maneuver and supraglottic swallow, the effortful swallow is an intervention strategy used commonly among patients with severe dysphagia. During the pharyngeal phase, when the bolus is advanced from the pharynx to the esophagus, the swallow is modified by placing it under voluntary control. Effortful swallowing has been recommended for years because it increases the oral and pharyngeal pressure and helps clear a bolus.
The technique of the effortful swallow is designed to improve tongue base contact to the posterior pharyngeal wall during the swallow. The patient is instructed to “squeeze” all throat and neck muscles hard as they swallow. This act of a hard swallow helps clear the pathway.
Logemann, J. (1998). Evaluation and Treatment of Swallowing Disorders, 2nd ed. pp. 221-222. Austin: ProEd.
Understanding the Normal Swallowing Process (focusing on pharyngeal phase)
Three phases of the normal swallowing process:
1. Oral phase (images A, B, and C)
2. Pharyngeal phase (images D and E)
- the bolus moves through the pharynx while the elevation and retraction of the velum lead to velopharyngeal closure
- the bolus moves further into the pharynx by the backward movement of the tongue base
- the hyoid bone and larynx elevate, and the cricopharyngeal muscle relaxes as the bolus passes into the esophagus
3. Esophogeal phase (image F)
Posted by Katherine Duncan