A small flap of cartilage located in the throat, the epiglottis typically remains upright and allows air to pass freely into the larynx and lungs. When you swallow, however, the epiglottis inverts to cover the larynx and prevent liquids and foods from entering the airway and lungs. Once swallowing is complete, the epiglottis returns to its upright position. In rare cases, the epiglottis remains immobile and does not invert during a swallow, leaving the airway open to foreign particles. Exercises for epiglottic inversion can help encourage proper movement of the epiglottis and prevent aspiration during swallowing 2.
Throughout the Mendelsohn Maneuver exercise, your epiglottis remains inverted to prevent the aspiration of saliva into your airways. Begin by swallowing your saliva several times. If your mouth is unusually dry, you may take small sips of water instead. As you swallow, pay attention to how your throat feels as you swallow. You should feel your larynx lift and lower each time you swallow. Once the movement is familiar, swallow again and feel your larynx lifting. However, do not let your larynx drop this time. Engage your throat and hold the larynx in the lifted position for two to three seconds before letting it drop. Repeat the Mendelsohn exercise five times daily.
If the immobile epiglottis is caused by a neurologic problem, strengthening the muscles underneath the chin could help resolve the problem. The Shaker exercise focuses on these specific muscles, known as the hyolaryngeal muscles. To begin, lie flat on your back on the ground or bed. Without lifting your shoulders, raise your head off the ground and look at your toes. Hold this position for 60 seconds and then lower your head. Rest for 60 seconds and repeat this sequence three times. Then, lift and lower your head in quick successions 30 times. Rest for 60 seconds and repeat the entire sequence three times daily.
Occasionally, epiglottic exercises cannot accurately treat and/or repair the damaged epiglottis. In fact, the Dysphagia Resource Center website explains that epiglottic immobility may not even correct itself after months of regular exercise. In these cases, the patient should use postural changes to assist with swallowing and prevent aspiration. Postural changes might include turning the head toward the stronger side and/or tucking the chin while swallowing.
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