Findings

Epiglottic inversion

Also written as Epiglottic movement, Epiglottic deflection, Epiglottic tilt, Absent epiglottic inversion, Partial epiglottic inversion, Reduced epiglottic inversion.

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

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.

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.