Figure 7 - a: Example of esophagoglottal closure reflex evoked by 20 mL room air injected into mid-esophagus.

Vocal cords immediately before the onset of adduction during esophageal air injection (i). Vocal cords maximally adducted (ii). Vocal cords returned to resting position 1.42 sec after the onset of vocal cord adduction (iii). m, Manometric catheters. (Source: Shaker et al.⁵ with permission from American Gastroenterological Association) b: Examples of esophagoglottal closure reflex evoked by midesophageal balloon. Vocal cords immediately prior to balloon distention (i). Vocal cords maximally adducted during balloon distention (ii). Vocal cords returned to resting position (iii). Kinematics of the cords are similar to those of esophagoglottal closure reflex evoked by esophageal air distention. c: Examples of esophagoglottal closure reflex evoked by a spontaneous reflux event. As seen, vocal cords closed and opened (top of the panel) following a reflux event, resulting in a pH drop in the distal and proximal esophagus as well as common cavity. Development of common cavity following the stimulation of esophagoglottal closure reflex also resulted in secondary esophageal peristalsis (2° peristalsis). EGR, esophagoglottal reflex