Swallowing Dysfunction after Tracheostomy

Bonanno, Philip C.

doi:10.1097/00000658-197107010-00005

Cited by 214 publications

(97 citation statements)

References 18 publications

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“…Our own patients reported diminished participation in social activities at least partially due to dependency on and appearance of tracheostomy. Several complications are related to tracheostomy tubes, such as obstruction, chronic aspiration, dysphagia, pulmonary infections, fistula formation or bleeding ulcerations, which all can have devastating or even life-threatening consequences (9)(10)(11)44). Therefore, decannulation after FT improves quality of life and prevents for potentially lethal complications.…”

Section: Discussionmentioning

confidence: 99%

“…In severely disfigured patients, absence of nasal passage, narrowed naso-and velopharyngeal spaces or inadequate mouth opening hinder adequate respiration and tracheostomy becomes necessary. Tracheostomy involves complications such as dysphagia and fistula formation, which are associated with high risk of mortality (9,11,12). FT restores masticatory function, the oral cavity and the upper airway in a single stage procedure (13).…”

Section: Introductionmentioning

confidence: 99%

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Functional Outcomes of Face Transplantation

Fischer

Kueckelhaus

Pauzenberger

et al. 2015

American Journal of Transplantation

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In this study we provide a compilation of functional impairments before and improvements after face transplantation (FT) of five FT recipients of our institution and all FTs reported in current literature. Functional outcome included the ability to smell, breath, eat, speak, grimace and facial sensation. Before FT, all our patients revealed compromised ability to breath, eat, speak, grimace and experience facial sensation. The ability to smell was compromised in two of our five patients. Two patients were dependent on tracheostomy and one on gastrostomy tubes. After FT, all abilities were significantly improved and all patients were independent from artificial air airways and feeding tubes. Including data given in current literature about the other 24 FT recipients in the world, the abilities to smell, eat and feel were enhanced in 100% of cases, while the abilities of breathing, speaking and facial expressions were ameliorated in 93%, 71% and 76% of cases, respectively. All patients that required gastrostomy and 91% of patients depending on tracheostomy were decannulated after FT. Unfortunately, outcomes remain unreported in all other cases and therefore we are unable to comment on improvements.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Functional Outcomes of Face Transplantation

Fischer

Kueckelhaus

Pauzenberger

et al. 2015

American Journal of Transplantation

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“…However, whether tracheostomies actually cause dysphagia and aspiration remains controversial. For many years, a causative link between tracheostomies and dysphagia and aspiration was believed to exist [53][54][55]. Studies suggested that even in the absence of neurological conditions, patients with tracheostomies risked dysphagia [56].…”

Section: Tracheostomymentioning

confidence: 99%

Management of Dysphagia Following Traumatic Brain Injury

Howle

Baguley

Brown

2014

Curr Phys Med Rehabil Rep

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Dysphagia is a common morbidity and cause of mortality following traumatic brain injury (TBI). Despite this, there is a paucity of evidence demonstrating the efficacy of dysphagia management strategies and treatments in this population. Typically, subjects with dysphagia following TBI are placed into non-specific 'neurogenic' dysphagia subject groups, which include subjects with degenerative neurological diseases, neurological cancers, and cerebrovascular accident. However, dysphagia following TBI has a multifactorial presentation, with causative and contributory factors including cognitivecommunication, behavioral, neurological, and mechanical issues. As such, the management for dysphagia post-TBI must be multifactorial, team-based and involve the patients' families and carers. Much of the research regarding the management and treatment of dysphagia in general is in its infancy: larger and more rigorous studies are required to demonstrate treatment efficacy. More studies specifically examining dysphagia and its management in the TBI population are required to ensure the future efficacy and accuracy of treatment.

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“…32 The causes of aspiration due to tracheostomy tube include abnormal anterior-superior movement of the larynx, reduced subglottic pressure, impaired laryngeal closure reflexes, and alterations of the oral, pharyngeal, and esophageal stages of swallowing. [32][33][34] Patients with premorbid diagnoses such as osteophytes and gastroesophageal reflux disease (GERD) may be at a higher risk for swallowing complications. Osteophytes can cause compression of the esophagus.…”

Section: Ventilation Managementmentioning

confidence: 99%