Strategies & exercises

Supraglottic swallow

Also written as supraglottic swallow maneuver, breath hold swallow, super-supraglottic swallow, SGS.

A swallowing technique that uses a breath hold before and during the swallow to close the vocal folds, followed by a cough.

"Supraglottic" means above the glottis — the opening between the vocal folds, which sits at the top of the windpipe. The technique is aimed at that area. ASHA describes the supraglottic swallow as designed to close the vocal folds by voluntarily holding one's breath before and during the swallow in order to protect the airway.

There is a specific sequence to it. ASHA describes the patient being instructed to hold their breath just before swallowing to close the vocal folds, and notes that the swallow is followed immediately by a volitional cough — a cough done on purpose, to help clear anything sitting near the airway afterward.

You may also see "super-supraglottic swallow" in a report. ASHA describes that related version as designed to voluntarily move the arytenoids forward, closing the entrance to the laryngeal vestibule before and during the swallow. It uses a firmer, bearing-down style breath hold, and it is a separate technique from the standard supraglottic swallow.

An SLP looks at airway protection — whether the airway closes well and at the right moment — and this technique targets that. Because it involves holding the breath and doing several steps in the right order, it is one clinicians choose carefully; ASHA notes some maneuvers require following multistep directions and may not be appropriate for patients with cognitive impairments. Your SLP may teach it to you if it fits your situation. Do not try a breath-hold swallow on your own based on a description.