What is the most appropriate initial intervention for a client with poor upper esophageal sphincter opening?

What is the most appropriate initial intervention for a client with poor upper esophageal sphincter opening?

• A. Thermotactile stimulation
• B. Mendelsohn maneuver
• C. Thickened liquids
• D. Chin-down posture

Answer: (B)

The most appropriate initial intervention for a client with poor upper esophageal sphincter (UES) opening is the Mendelsohn maneuver. This technique involves the voluntary prolongation of the swallow to improve UES opening and coordination. When performed correctly, it helps to enhance the duration of UES opening during swallowing, which can facilitate the passage of food from the pharynx into the esophagus, thereby reducing the potential for aspiration and improving swallowing safety. Understanding the importance of improving UES function is critical, as a poorly opening sphincter can lead to various complications, including aspiration, residue in the throat, and the sensation of a “stuck” feeling during swallowing. The Mendelsohn maneuver directly targets this issue, making it an effective therapeutic approach at the outset of treatment for individuals presenting with this specific dysfunction. Other interventions, while valuable in certain contexts, do not provide the same direct focus on improving UES opening. For example, thermotactile stimulation is often applied to enhance sensory awareness and may not directly impact UES function. Thickened liquids can help minimize aspiration but do not address the mechanical aspect of the sphincter opening. Similarly, a chin-down posture can help reduce aspiration risk by changing the swallowing dynamics

The most appropriate initial intervention for a client with poor upper esophageal sphincter (UES) opening is the Mendelsohn maneuver. This technique involves the voluntary prolongation of the swallow to improve UES opening and coordination. When performed correctly, it helps to enhance the duration of UES opening during swallowing, which can facilitate the passage of food from the pharynx into the esophagus, thereby reducing the potential for aspiration and improving swallowing safety.

Understanding the importance of improving UES function is critical, as a poorly opening sphincter can lead to various complications, including aspiration, residue in the throat, and the sensation of a “stuck” feeling during swallowing. The Mendelsohn maneuver directly targets this issue, making it an effective therapeutic approach at the outset of treatment for individuals presenting with this specific dysfunction.

Other interventions, while valuable in certain contexts, do not provide the same direct focus on improving UES opening. For example, thermotactile stimulation is often applied to enhance sensory awareness and may not directly impact UES function. Thickened liquids can help minimize aspiration but do not address the mechanical aspect of the sphincter opening. Similarly, a chin-down posture can help reduce aspiration risk by changing the swallowing dynamics