From the Guidelines
No, you cannot consciously control the opening and closing of your epiglottis on demand. The epiglottis is a leaf-shaped cartilaginous structure that functions automatically as part of your swallowing reflex. When you swallow, it folds down to cover your larynx (voice box), preventing food and liquid from entering your airway and directing them into your esophagus instead. This protective mechanism occurs involuntarily through complex neurological pathways coordinated by your brainstem. Unlike voluntary muscles that you can consciously control, such as those used for speaking or breathing, the movements of the epiglottis are regulated by autonomic reflexes that respond to the presence of food or liquid in your throat.
The provided evidence from the ESPEN guideline on clinical nutrition in neurology 1 and the ACCP evidence-based clinical practice guidelines on cough and aspiration of food and liquids due to oral-pharyngeal dysphagia 2 supports the idea that the epiglottis functions automatically and is not under conscious control. Various studies and techniques discussed in these guidelines, such as the Shaker head lift, chin-down, and expiratory muscle strength training, aim to improve swallowing function and reduce aspiration risk, but they do not involve direct conscious control of the epiglottis.
Some key points to consider:
- The epiglottis plays a crucial role in preventing aspiration during swallowing, and its movement is regulated by autonomic reflexes.
- Techniques like the Shaker head lift and chin-down can help improve swallowing function and reduce aspiration risk, but they do not involve conscious control of the epiglottis.
- Surgical interventions, such as supracricoid partial laryngectomy and petiole supraglottopexy, can be used to prevent aspiration in severe cases, but they are not related to conscious control of the epiglottis.
- The evidence suggests that the epiglottis functions automatically, and its movement is not under conscious control, which is essential for safety during eating and drinking.
From the Research
Control of Epiglottis Movement
The control of the epiglottis, a flap-like structure located at the entrance of the larynx, is crucial for preventing food and liquid from entering the airway during swallowing. The question of whether one can control the closing and opening of the epiglottis on demand is complex and involves the coordination of various muscles and neural mechanisms.
Muscular Control
- The movement of the epiglottis is influenced by the intrinsic and extrinsic muscles of the larynx, as well as the muscles of the tongue, pharynx, and neck 3.
- The posterior cricoarytenoid muscle plays a key role in opening the laryngeal airway, while the thyrohyoid, cricothyroid, sternohyoid, and inferior constrictor muscles are involved in closing the airway 3.
Neurophysiological Control
- The control of swallowing, including the movement of the epiglottis, is a complex process that involves the coordination of multiple neural pathways and centers in the brainstem and higher brain regions 4.
- The normal swallow involves the precise coordination of movements within the oral cavity, pharynx, larynx, and esophagus, and is controlled by a network of neurons in the brainstem and spinal cord 4.
Voluntary Control
- There is limited evidence to suggest that individuals can voluntarily control the movement of the epiglottis on demand.
- Studies have shown that effortful swallowing maneuvers can increase muscle activity in the suprahyoid muscles, but do not appear to have a significant effect on cardiac autonomic control or the movement of the epiglottis 5.
- Further research is needed to fully understand the extent to which voluntary control is possible and the mechanisms involved.