Saturday, 22 January 2011

Epiglottis is not essential for successful swallowing in humans.

Ann Otol Rhinol Laryngol. 2010 Dec;119(12):795-8.

Epiglottis is not essential for successful swallowing in humans.
Leder SB, Burrell MI, Van Daele DJ.

Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut 06520-8041, USA. steven.leder@yale.edu

Abstract
Controversy has continued for well over 100 years regarding the role of the epiglottis in deglutition. We describe the effect of isolated epiglottectomy on swallowing success in a case series of 3 adult human subjects with isolated epiglottectomy due to trauma, surgery, or cancerous erosion. The patients were 42, 51, and 70 years of age, and swallowing was analyzed objectively with videofluoroscopy. All subjects exhibited successful swallowing with all food types: thin liquid, puree, and solid food. Specifically, the patient with traumatic epiglottectomy exhibited rapid swallowing success, the patient with surgical epiglottectomy exhibited a short period of dysphagia due to postoperative edema, followed by swallowing success, and the patient with epiglottectomy due to cancerous erosion of the entire epiglottis exhibited long-term adaptation, with successful swallowing maintained. We conclude that the epiglottis is not essential for successful swallowing in humans, because individuals can readily adapt to isolated epiglottectomy and avoid tracheal aspiration.

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