Chin-down posture effect on aspiration in dysphagic patients.

Use of the chin-down posture during swallowing has been reported to reduce the occurrence of aspiration in some dysphagic patients. This study measured four pharyngeal dimensions in 30 neurologically impaired patients who aspirated before the swallow because of a delay in triggering the pharyngeal swallow, 15 for whom the posture eliminated aspiration and 15 who aspirated despite the chin-down position. Patients who did not benefit from the posture were significantly younger and aspirated material from the pyriform sinus rather than the valleculae when the pharyngeal swallow was triggered. Changes in pharyngeal dimensions with the chin down were not significantly different for both patient groups, except for epiglottic angle, which increased significantly more in the group who continued to aspirate. Changes in pharyngeal dimensions with chin-neutral versus chin-down differed somewhat from those reported in a previous publication. Possible reasons for these differences are discussed.