Occlusion of Tracheostomy Tubes Does Not Alter Pharyngeal Phase Kinematics But Reduces Penetration by Enhancing Pharyngeal Clearance

Ledl, Christian; Ullrich, Ylva Yasmin

doi:10.1097/phm.0000000000000602

Cited by 17 publications

(40 citation statements)

References 15 publications

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Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

“…Of the 10 accepted articles (Table 1), all were prospective case series [39][40][41][42][43][44][45][46][47]. Study sample sizes ranged from 11 [40] to 40 [42] patients and included heterogeneous diagnoses in all but two studies [41,45]. Nine of the included studies [39][40][41][42][43][44][45][46]48] were published in English and one was published in Japanese [47].…”

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

“…We assessed study quality using the Cochrane Collaboration's risk of bias tool [28] (Table 2). Four studies [42,45,46,48] declared their patient selection/sampling methods with six [40,41,[45][46][47][48] declaring their inclusion and exclusion criteria. Of the 10 studies, two [43,46] declared blinding of outcome assessors; however, none reported on patient blinding.…”

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

“…Of the 10 studies, two [43,46] declared blinding of outcome assessors; however, none reported on patient blinding. Nine studies [39][40][41][42][44][45][46][47][48] had no missing outcome data and six studies [40][41][42][45][46][47] did not have selective outcome reporting. All 10 [39][40][41][42][43][44][45][46][47][48] operationally defined their outcome measures with seven studies [39-41, 43-45, 47] using operational definitions for tracheostomy conditions/modifications.…”

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

“…Six studies had portions of their patient sample meeting our inclusion criteria; however, they were excluded following author contact as the pertinent outcomes were not extractable [19,30,33,[36][37][38]. A total of 10 articles were accepted for analysis [39][40][41][42][43][44][45][46][47] (Table 1).…”

Section: Literature Retrievedmentioning

confidence: 99%

See 4 more Smart Citations

A Systematic Review of Tracheostomy Modifications and Swallowing in Adults

et al. 2020

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Dysphagia occurs in 11% to 93% of patients following tracheostomy. Despite its benefits, the tracheostomy often co-exists with dysphagia given its anatomical location, the shared pathway of the respiratory and alimentary systems, and the medical complexities necessitating the need for the artificial airway. When tracheostomy weaning commences, it is often debated whether the methods used facilitate swallowing recovery. We conducted a systematic review to determine whether tracheostomy modifications alter swallowing physiology in adults. We searched eight electronic databases, nine grey literature repositories and conducted handsearching. We included studies that reported on oropharyngeal dysphagia as identified by instrumentation in adults with a tracheostomy. We accepted case series (n > 10), prospective or retrospective observational studies, and randomized control trials. We excluded patients with head and neck cancer and/or neurodegenerative disease. Two independent and blinded reviewers rated abstracts and articles for study inclusion. Data abstraction and risk of bias assessment was conducted on included studies. Discrepancies were resolved by consensus. A total of 7079 citations were identified, of which, 639 articles were reviewed, with ten articles meeting our inclusion criteria. The studies were heterogeneous in study design, patient population, and outcome measures. For these reasons, we presented our findings descriptively. All studies were limited by bias risk. This study highlights the limitations of the evidence and therefore the inability to conclude whether tracheostomy modifications alter swallowing physiology.

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Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

Section: Literature Retrievedmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of Tracheostomy Modifications and Swallowing in Adults

et al. 2020

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Tracheostomy managment and tube weaning within a framework of dysphagia intervention

2023

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Changes in Swallowing and Cough Functions Among Stroke Patients Before and After Tracheostomy Decannulation

Park

Lee

2018

Dysphagia

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We investigated the functional changes in swallowing and voluntary coughing before and after tracheostomy decannulation among stroke patients who had undergone a tracheostomy. We also compared these functions between stroke patients who underwent tracheostomy tube removal and those who did not within 6 months of their stroke. Seventy-seven stroke patients who had undergone a tracheostomy were enrolled. All patients were evaluated by videofluoroscopic swallowing studies and a peak flow meter through the oral cavity serially until 6 months after their stroke. During the intensive rehabilitation period, if a patient satisfied the criteria for tracheostomy tube removal, the tube was removed. The patients were divided into the 'decannulated' group and the 'non-decannulated' group according to their tracheostomy tube removal status. In the decannulated group, swallowing function did not change before and after tracheostomy decannulation; however, cough function was significantly improved after decannulation. Although both groups exhibited functional improvement in swallowing and coughing over time, the improvement in the decannulated group was more significant than the improvement in the non-decannulated group. Our results revealed that stroke patients who had better functional improvement in swallowing and coughing were more likely to be potential candidates for tracheostomy decannulation. Stroke patients who recovered from neurogenic dysphagia, they were no longer affected by the mechanical effect of the tracheostomy tube on swallowing function. This study suggests that if patients show improvement in swallowing and coughing after their stroke, a multidisciplinary approach to tracheostomy decannulation would be needed to achieve better rehabilitation outcomes.

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Occlusion of Tracheostomy Tubes Does Not Alter Pharyngeal Phase Kinematics But Reduces Penetration by Enhancing Pharyngeal Clearance

Cited by 17 publications

References 15 publications

A Systematic Review of Tracheostomy Modifications and Swallowing in Adults

A Systematic Review of Tracheostomy Modifications and Swallowing in Adults

Tracheostomy managment and tube weaning within a framework of dysphagia intervention

Changes in Swallowing and Cough Functions Among Stroke Patients Before and After Tracheostomy Decannulation

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