Effects of the Removal of the Tracheotomy Tube on Swallowing During the Fiberoptic Endoscopic Exam of the Swallow (FEES) |
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Authors: | Joseph Donzelli MD Susan Brady MS CCC-SLP Michele Wesling MA CCC-SLP Melissa Theisen MA CCC-SLP |
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Institution: | (1) Otolaryngology, Head & Neck Surgery, Ltd., Naperville, Illinois;(2) Department of Speech Language Pathology, Marianjoy Rehabilitation Hospital, Wheaton, Illinois, USA;(3) Department of Speech Language Pathology, Marianjoy Rehabilitation Hospital, Research Coordinator Swallowing & Voice Center, 26 West 171 Roosevelt Road, Wheaton, EL 60187, USA |
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Abstract: | This study investigated the effects, if any, that the presence of a tracheotomy tube has on the incidence of laryngeal penetration
and aspiration in patients with a known or suspected dysphagia. This was a prospective, repeated-measure design study. A total
of 37 consecutive patients with a tracheotomy tube underwent a fiberoptic endoscopic evaluation of swallowing (FEES). Patients
were first provided with pureed food boluses with the tracheotomy tube in place. The tracheotomy tube was then removed and
the tracheostoma site was covered with gauze and gentle hand pressure was applied. The patients were then evaluated without
the tracheotomy tube in place with additional puree. Aspiration status was in agreement with and without the tracheotomy tube
in place in 95% (35/37) of the patients. The two patients who demonstrated a different swallowing pattern with regard to aspiration
demonstrated aspiration only when the tracheotomy tube was removed. Laryngeal penetration status was in agreement with and
without the tracheotomy tube in place in 78% (29/37) of the patients. For the majority of the patients, the removal of the
tracheotomy tube made no difference in the incidence of aspiration and/or laryngeal penetration. Results of this study do
not support the clinical notion that the patient’s swallowing function will improve once the tracheotomy tube has been removed.
Work for this project was completed at Marianjoy Rehabilitation Hospital, Wheaton, Illinois. |
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Keywords: | Tracheotomy tube Dysphagia Rehabilitation Aspiration Secretions Deglutition Deglutition disorders |
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