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The Effects of Breath-Holding on Vocal Fold Adduction
Implications for Safe Swallowing
Joseph Donzelli, MD;
Susan Brady, MS
Arch Otolaryngol Head Neck Surg. 2004;130:208-210.
Objective To determine the effects, if any, of 3 different breath-holding techniques on a person's ability to attain vocal fold closure (VFC) to successfully complete swallowing maneuvers.
Design Prospective, randomized study.
Setting Private practice.
Patients A total of 150 healthy volunteers recruited from private practice patients and community volunteers.
Intervention Group 1 received the easy breath-hold instruction; group 2 received the inhale/easy breath-hold instruction; and group 3 received the hard breath-hold instruction.
Main Outcome Measure Closure of true and false vocal folds following the breath-hold instruction.
Results In the easy breath-hold group, true VFC occurred in 82% of the subjects, and closure of both the true and false vocal folds occurred in 30%. In the inhale/easy breath-hold group, true VFC occurred in 62%, and closure of both folds occurred in 46%. In the hard breath-hold group, true VFC occurred in 86%, and closure of both folds occurred in 64%. The differences among the 3 groups were significant for true VFC ( 2 = 9.242; P = .01) and for closure of both folds (2 = 11.625; P = .003).
Conclusions The hard breath-hold instruction was the most effective method to attain full laryngeal closure, and the inhale/easy breath-hold instruction was the least effective method to attain true VFC for safe swallowing.
From Otolaryngology Head & Neck Surgery LTD, Naperville, Ill (Dr Donzelli), and the Department of Speech-Language Pathology, Marianjoy Rehabilitation Hospital, Wheaton, Ill (Ms Brady). The authors have no relevant financial interest in this article.
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