Airway Protective Responses in Infants
Airway Protective Responses in Infants
In infants, the primary mechanism for airway protection is the laryngeal chemoreflex (LCR). It includes:
👉🏻 Repeated/ Rapid swallowing
👉🏻 Apnea
👉🏻 Laryngeal constriction
👉🏻 Bradycardia
Growing up, cough become the more prominent airway protection mechanism. Other protective mechanisms include the gag reflex, mucociliary escalator, the immune system (e.g. phagocytosis). [Ref. Pediatric otolaryngoloy by Bluestone and Stool's]
What about the relationship between gag reflex and swallowing safety?
[with reference to Gray's Anatomy:]
👉🏻 There's little relationship between a functioning gag reflex and the ability to swallow normally/ risk of aspiration.
👉🏻 Individuals with a reduced or absent gag reflex can swallow safely; conversely, the presence of a brisk and clear gag reflex is not always associated with the ability to swallow safely.
[with reference to (BLEACH, 1993)]
👉🏻 Normal individuals may exhibit a delayed or absent gag, without dysphagia or aspiration
👉🏻 No association between an absent gag reflex and aspiration
Still, absence of the gag reflex can be a symptom of severe medical conditions that result in damage to the glossopharyngeal nerve, the vagus nerve, or brain.
So, always be holistic in your evaluation!
👉🏻 Repeated/ Rapid swallowing
👉🏻 Apnea
👉🏻 Laryngeal constriction
👉🏻 Bradycardia
Growing up, cough become the more prominent airway protection mechanism. Other protective mechanisms include the gag reflex, mucociliary escalator, the immune system (e.g. phagocytosis). [Ref. Pediatric otolaryngoloy by Bluestone and Stool's]
What about the relationship between gag reflex and swallowing safety?
[with reference to Gray's Anatomy:]
👉🏻 There's little relationship between a functioning gag reflex and the ability to swallow normally/ risk of aspiration.
👉🏻 Individuals with a reduced or absent gag reflex can swallow safely; conversely, the presence of a brisk and clear gag reflex is not always associated with the ability to swallow safely.
[with reference to (BLEACH, 1993)]
👉🏻 Normal individuals may exhibit a delayed or absent gag, without dysphagia or aspiration
👉🏻 No association between an absent gag reflex and aspiration
Still, absence of the gag reflex can be a symptom of severe medical conditions that result in damage to the glossopharyngeal nerve, the vagus nerve, or brain.
So, always be holistic in your evaluation!