Which swallowing technique is recommended to help prevent aspiration for a patient with myasthenia gravis during swallowing?

Which swallowing technique is recommended to help prevent aspiration for a patient with myasthenia gravis during swallowing?

• A. Head tilt during swallowing
• B. Swallow twice rapidly
• C. Chin tuck during swallowing
• D. Drink only thickened fluids

Answer: (C)

In myasthenia gravis, bulbar muscles weaken with fatigue, making safe swallowing a priority. The chin-tuck maneuver—tucking the chin toward the chest during swallowing—changes the way the bolus moves and protects the airway. By tilting the larynx backward and narrowing the space behind the tongue, it helps direct the bolus through the more straightforward anterior path and enhances epiglottic closure, reducing the chance that material enters the airway. This compensatory posture is especially useful when there’s delayed swallow onset or reduced posterior pharyngeal movement, both common in MG. Head tilt toward a stronger side is intended for unilateral weakness and isn’t reliably protective in diffuse bulbar weakness. Swallowing twice rapidly can worsen fatigue in MG and increase aspiration risk. Drinking only thickened fluids is a diet modification, not a swallowing technique, though it may reduce aspiration risk in some cases.

In myasthenia gravis, bulbar muscles weaken with fatigue, making safe swallowing a priority. The chin-tuck maneuver—tucking the chin toward the chest during swallowing—changes the way the bolus moves and protects the airway. By tilting the larynx backward and narrowing the space behind the tongue, it helps direct the bolus through the more straightforward anterior path and enhances epiglottic closure, reducing the chance that material enters the airway. This compensatory posture is especially useful when there’s delayed swallow onset or reduced posterior pharyngeal movement, both common in MG.

Head tilt toward a stronger side is intended for unilateral weakness and isn’t reliably protective in diffuse bulbar weakness. Swallowing twice rapidly can worsen fatigue in MG and increase aspiration risk. Drinking only thickened fluids is a diet modification, not a swallowing technique, though it may reduce aspiration risk in some cases.