Aspiration and penetration tests
Typically, a child with a laryngeal cleft will experience various difficulties with swallowing and breathing. As a result, medical providers may refer the child for testing to determine if aspiration or laryngeal penetration is occurring during swallowing. While most children with a symptomatic laryngeal cleft will show signs of aspiration, a small minority will only have breathing problems.
Aspiration vs. penetration
Aspiration occurs when food, liquids, or secretions travel down through the vocal cords and enter the trachea. This can provoke a number of symptoms and can be caused by a variety of conditions, including a laryngeal cleft. Laryngeal penetration occurs when food, liquids, or secretions enter the larynx, but remain above the vocal cords. Generally, penetration is considered more mild than aspiration, but neither should occur in a normal swallow. If aspiration is suspected, one of the following tests may help confirm or rule it out.
Testing options
A variety of tests can help show if aspiration or penetration is occurring:
Modified Barium Swallow Study (MBSS) or Videofluoroscopic Swallowing Study (VFSS)
Clinical feeding evaluation
Modified Evan’s blue dye test - tracheostomy patients only