Dysphagia

, Volume 20, Issue 4, pp 283–289 | Cite as

Effects of the Removal of the Tracheotomy Tube on Swallowing During the Fiberoptic Endoscopic Exam of the Swallow (FEES)

  • Joseph Donzelli
  • Susan Brady
  • Michele Wesling
  • Melissa Theisen
Article

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.

Keywords

Tracheotomy tube Dysphagia Rehabilitation Aspiration Secretions Deglutition Deglutition disorders 

Notes

Acknowledgments

The Dr. Ralph and Marian Falk Foundation Medical Research Trust provided funding for this project. The authors thank Dr. Steven Leder for his assistance with the manuscript.

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Joseph Donzelli
    • 1
  • Susan Brady
    • 2
    • 3
  • Michele Wesling
    • 2
  • Melissa Theisen
    • 2
  1. 1.OtolaryngologyHead & Neck Surgery, Ltd.Naperville
  2. 2.Department of Speech Language PathologyMarianjoy Rehabilitation HospitalWheatonUSA
  3. 3.Department of Speech Language PathologyMarianjoy Rehabilitation Hospital, Research Coordinator Swallowing & Voice CenterWheatonUSA

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