Effects of the removal of the tracheotomy tube on swallowing during the fiberoptic endoscopic exam of the swallow (FEES)

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 tracheot...

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Bibliographic Details
Published in:Dysphagia 2005-10, Vol.20 (4), p.283-289
Main Authors: Donzelli, Joseph, Brady, Susan, Wesling, Michele, Theisen, Melissa
Format: Article
Language:English
Subjects:
Aged
Analysis of Variance
Care and treatment
Deglutition
Deglutition - physiology
Deglutition disorders
Deglutition Disorders - diagnosis
Deglutition Disorders - etiology
Device Removal
Esophagoscopy - methods
Female
Fiber Optic Technology
Follow-Up Studies
Humans
Male
Middle Aged
Patient outcomes
Physiological aspects
Pneumonia, Aspiration - diagnosis
Pneumonia, Aspiration - etiology
Probability
Prospective Studies
Risk Assessment
Time Factors
Tracheotomy
Tracheotomy - instrumentation
Tracheotomy - methods
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Summary: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.
ISSN:0179-051X
1432-0460
DOI:10.1007/s00455-005-0027-8