The Mendelsohn Maneuver

RCD is characterized by the inappropriate contraction of the cricopharyngeus muscle during swallowing. This muscle, which forms part of the upper esophageal sphincter, should relax to allow food and liquid to pass from the throat to the esophagus. In RCD, the muscle's failure to relax properly can lead to:

• Difficulty swallowing (dysphagia)

• Regurgitation of food or liquids through the nose

• Sensation of food getting stuck in the throat

• Increased risk of aspiration pneumonia

The Mendelsohn Maneuver, named after speech-language pathologist Martin Mendelsohn, is a swallowing technique designed to improve the elevation and forward movement of the larynx (voice box) during swallowing. This movement is crucial for proper opening of the upper esophageal sphincter.

How the Mendelsohn Maneuver Works

The maneuver works by:

1. Prolonging the duration of laryngeal elevation during the swallow

2. Increasing the width and duration of upper esophageal sphincter opening

3. Improving coordination of the swallowing process

These effects can be particularly beneficial for individuals with RCD, as they help counteract the inappropriate muscle contractions characteristic of the disorder.

Performing the Mendelsohn Maneuver: A Step-by-Step Guide

Here's how to perform the Mendelsohn Maneuver:

1. Preparation:

   • Sit upright in a comfortable position

   • If possible, have a small amount of water ready (only if deemed safe by your healthcare provider)

2. Locate Your Larynx:

   • Place your fingertips gently on your neck

   • Swallow normally and feel your larynx rise and fall

3. Initiate a Swallow:

   • Take a small sip of water (if safe) or use your saliva

   • Begin to swallow normally

4. Hold the Elevation:

   • As you feel your larynx rise during the swallow, consciously hold it in the elevated position

   • Maintain this elevation for 2-3 seconds

5. Complete the Swallow:

   • After holding, allow your larynx to lower naturally, completing the swallow

6. Practice:

   • Repeat this process 5-10 times per session

   • Aim for 3-5 sessions per day, or as recommended by your speech-language pathologist

Tips for Success

• Focus on Quality: It's better to perform fewer, high-quality maneuvers than many rushed or improper ones

• Use a Mirror: Watching yourself in a mirror can help you visualize the laryngeal movement

• Be Patient: Mastering this technique takes time and practice

• Stay Consistent: Regular practice is key to seeing improvements

Safety Considerations

While the Mendelsohn Maneuver is generally safe, it's crucial to:

• Only attempt this technique under the guidance of a qualified speech-language pathologist

• Stop immediately if you experience any discomfort or difficulty

• Follow all recommendations from your healthcare team regarding safe swallowing practices

Integrating the Mendelsohn Maneuver into Daily Life

Once you've mastered the technique with the help of a professional, you can begin to incorporate it into your regular swallowing routine. Many individuals find it helpful to use the maneuver with every few swallows during meals, especially when consuming challenging textures.

The Mendelsohn Maneuver is a powerful tool in the management of Retrograde Cricopharyngeus Dysfunction. By improving laryngeal elevation and upper esophageal sphincter opening, it can significantly enhance swallowing function and quality of life for those affected by RCD.

Remember, while this article provides a general guide, it's essential to work closely with a speech-language pathologist or swallowing specialist. They can provide personalized instruction, ensure you're performing the technique correctly, and monitor your progress over time.

With patience, practice, and proper guidance, the Mendelsohn Maneuver can be a game-changer in managing RCD and improving overall swallowing function.