Swallowing Disorders after Oral Cavity and Pharyngolaryngeal Surgery and Role of Imaging

Table 4

Postures used for eliminating aspiration or residue, the disorders they are designed to address, and the rationale for their use [19, 21].

Disorders on videofluoroscopic swallow	Posture applied	Rationale
Inefficient oral transit	Head back	Gravity to clear oral cavity [22]
Delay in triggering the pharyngeal swallow	Chin down	Widens valleculae, stop bolus entering airways [23]
Reduced posterior tongue base movement	Chin down	Pushes the tongue back toward pharyngeal wall [24]
Unilateral vocal fold palsy, surgical removal of vocal cord (aspiration during swallow)	Head rotated to affect side	Directs bolus down stronger side, improves vocal cold closure [22, 25]
Reduced closure of laryngeal entrance and vocal folds (aspiration during swallow)	Chin down; Head rotated to affect side	Improves protective position of epiglottis, narrows laryngeal entrance [24]
Unilateral pharyngeal palsy	Head rotated to affect side	Directs bolus down stronger side of pharynx [24, 25]
Reduced pharyngeal contraction	Lying down on one side	Eliminating gravity effect on laryngeal residue
Unilateral oral and pharyngeal weakness	Head rotated to damaged side	Directs bolus down stronger side by gravity
Cricopharyngeal dysfunction (residue in pyriform sinuses)	Head rotated	Pulls cricoid cartilage from posterior pharyngeal wall reducing pressure at cricopharyngeal junction