# Epiglottic inversion: plain-language definition

Canonical: [https://followyourswallow.com/glossary/epiglottic-inversion](https://followyourswallow.com/glossary/epiglottic-inversion)

Epiglottic inversion is the flap at the top of the voice box folding down over the airway during the swallow.

## In plain language

The epiglottis is a flap that sits at the entrance to the voice box, which clinicians call the larynx. During a swallow, the throat lifts and that flap tips backward and down over the airway opening. Clinicians call that folding motion epiglottic inversion. It happens in two steps: the flap first swings to about horizontal, and then folds the rest of the way down into full inversion.

A report may describe the movement as complete, partial, or absent. Researchers studying swallow x-ray studies have scored it in exactly those three ways: complete inversion, partial inversion, or no inversion. Epiglottic inversion is also one of the individually named physiologic components that clinicians score one at a time when reviewing a modified barium swallow study, instead of judging the swallow as a single pass or fail. It can be commented on during a FEES exam as well, where the throat is viewed through a small camera.

The flap does not move under its own power. It is folded down by the movements around it, mainly the voice box rising and the base of the tongue pulling back. One study of 92 patients found that reduced tongue base retraction and reduced laryngeal elevation were what underlay impaired epiglottic movement. So a note about the epiglottis describes one moment inside a longer sequence. It is recorded alongside many other observations from the same study and is not a diagnosis on its own.


## Why a clinician looks at this

An SLP looks at the epiglottis because its folding is one layer of the protection that closes the airway during a swallow, and because it rarely acts alone: the flap is driven by the voice box lifting and the tongue base retracting, so a note about it points the team toward those movements too. On FEES, an absent inversion rating has been associated with a broader, overall reduction in swallowing mechanics rather than a single isolated problem. This is one line in a study that contains many, and it does not tell you anything about your own result.

## Sources

- [Martin-Harris B, Jones B. "The Videofluorographic Swallowing Study." Physical Medicine and Rehabilitation Clinics of North America, 2008. PMC2586156.](https://pmc.ncbi.nlm.nih.gov/articles/PMC2586156/)
- [Pearson WG, Taylor BK, Blair J, Martin-Harris B. Computational analysis of swallowing mechanics underlying impaired epiglottic inversion. The Laryngoscope, 2016. PMID 27426940.](https://pubmed.ncbi.nlm.nih.gov/27426940/)
- [Jijakli A, Borders JC, Gottlieb A, et al. Absent epiglottic inversion as seen on flexible endoscopic evaluations of swallowing (FEES) is associated with a gestalt reduction in swallowing mechanics. American Journal of Otolaryngology, 2023. PMID 36753976.](https://pubmed.ncbi.nlm.nih.gov/36753976/)
- [Hoecker RN, Schweiger J, Prunier J, Dua A. "Aspiration Risk." StatPearls, NCBI Bookshelf, updated 2026. NBK470169.](https://www.ncbi.nlm.nih.gov/books/NBK470169/)

Source checked: 2026-08-17

Clinical review: SLP review in progress

## Safety

This is a general definition, not an interpretation of a person's report. Ask the clinician who performed the study what the term means for that person.