Disturbance of Swallowing After Tracheostomy

Feldman, Sid; Deal, Cedric W.; Urquhart, W.

doi:10.1016/s0140-6736(66)90951-2

Cited by 117 publications

(58 citation statements)

References 2 publications

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“…Feldman described three patients with disordered swallowing reflexes after tracheostomy. 10 This impaired reflex caused food and fluid to enter the larynx and cause aspiration. It was speculated that swallowing dysfunction resulted from desensitization of the larynx or a fixation of the larynx by the tracheostomy.…”

Section: Introductionmentioning

confidence: 99%

Dysphagia in individuals with tetraplegia: incidence and risk factors

Shem

Castillo

Wong

et al. 2011

The Journal of Spinal Cord Medicine

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Background/objective: Dysphagia following cervical spinal cord injury (SCI) can increase risk for pulmonary complications that may delay the rehabilitative process. The objective of this study was to identify risk factors for dysphagia after cervical SCI. Design: Prospective cohort study. Methods: Individuals with cervical SCI within 31 days of injury underwent a bedside swallow evaluation (BSE) followed by a videofluoroscopy swallow study (VFSS) within 72 hours of the BSE. Subjects were diagnosed as having dysphagia if they had positive findings in either BSE or VFSS. Results: Twenty-nine patients (7 female and 22 male) were enrolled. Of these, 21 (72%) had high cervical tetraplegia (C4 or higher) and 8 (38%) had lower cervical tetraplegia. A tracheostomy was present in 18 (62%) patients; 15 (52%) subjects were on ventilators. Dysphagia was diagnosed in 12 (41%) subjects. Dysphagia was noted in 62% of the subjects with tracheostomy and 53% of the subjects on the ventilator, but only tracheostomy resulted in a statistically significant association with dysphagia (P = 0.047). All three subjects who had nasogastric tubes were diagnosed with dysphagia (P = 0.029). The relationships between dysphagia and gender, high versus low tetraplegia, presence of halo or collar, head injury, and ventilator use were not statistically significant, but age was a significant risk factor (P = 0.028). Conclusions: Dysphagia is present in about 41% of individuals with acute tetraplegia. Only age, tracheostomy, and nasogastric tubes were identified as significant risk factors for dysphagia for individuals with tetraplegia. No relationship between dysphagia and level of SCI, spine surgery, collar, and ventilator use was found to exist.

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Section: Introductionmentioning

confidence: 99%

Dysphagia in individuals with tetraplegia: incidence and risk factors

Shem

Castillo

Wong

et al. 2011

The Journal of Spinal Cord Medicine

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“…3,4 In addition, the cuff also blocks expiratory airflow through the larynx, thereby obviating both phonation and airway clearance, as well as desensitizing the larynx. 5,6 It is important to investigate the differences in swallow physiology changes in patients with dysphagia with cuff deflated and cuff inflated to guide our use of cuff inflation in the clinical management of patients with dysphagia. No studies have investigated changes in swallow physiology between cuff-inflated and cuffdeflated conditions.…”

mentioning

confidence: 99%

Swallow physiology in patients with trach cuff inflated or deflated: A retrospective study

Ding

Logemann

2005

Head Neck

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“…They suggested the possible use of a standard mouthpiece with lip-seal retention or custommolded orthodontic bites for overnight use. In this population of subjects, mouthpiece ventilation use has progressively become a valid alternative to tracheostomy, providing benefits in terms of prevention of respiratory infections, reduction of complications associated with tracheostomy procedure and maintenance, 19 reduction in swallowing problems, 20 and improvement in cough, voice, and quality of life. 16,21 In this issue of RESPIRATORY CARE, Dr Nicolini and colleagues 22 report an interesting study in which they compared mouthpiece versus nasal mask ventilation to treat COPD exacerbation with mild to moderate acidosis.…”

Section: See the Original Study On Page 1825mentioning

confidence: 99%