Effect of Tracheostomy Tube on Swallowing in Patients with Stroke.

, Cha, Dong Yeon; , Yang, Hee Seung; , Noh, Ji Young; , Lee, Seon Young; , Choi, Jae Yung; , Kim, Sun Nye; , Park, Young Ok

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2010;34(2):128-133.

Cha, Dong Yeon , Yang, Hee Seung , Noh, Ji Young , Lee, Seon Young , Choi, Jae Yung , Kim, Sun Nye , Park, Young Ok

Department of Rehabilitation Medicine, Seoul Veterans Hospital, Korea. yang7310@naver.com

뇌졸중 환자에서 기관절개관 삽입이 연하에 미치는 영향

차동연, 양희승, 노지영, 이선영, 최재영, 김선녀, 박영옥

서울보훈병원 재활의학과

Abstract

Objective
To investigate the characteristics and severity of swallowing difficulties among stroke patients with a tracheostomy tube, compared to those without.
Method
A retrospective study was performed on two groups of 17 stroke patients with a tracheostomy tube (58.8 years) and without a tracheostomy tube (69.8 years) fed by Levine tube or a gastrostomy tube. There were no differences in the FIM (functional independence measure) score and brain lesions between the two groups. We evaluated the functional dysphagia scale (FDS) and aspiration; classified before, during, and after swallowing aspiration and silent aspiration. The swallowing task consisted of 2 ml of fluid and a videofluoroscopic swallowing study.
Results
There were no significant differences between the oral preparatory, oral and pharyngeal phase for the two groups in FDS. However, frequency of silent aspiration (p=0.007) and the total frequency of aspiration (p=0.038) were significantly higher in patients with tracheostomy.
Conclusion
Patients with stroke who underwent tracheostomy showed no meaningful difference in FDS. However, there were significant differences in terms of silent aspiration and the total frequency of aspiration; caused by laryngopharyngeal desensitization and the anterior tethering effect on the tracheostomy tube. We have to pay more attention to the treatment and care of patients with tracheostomy tubes. (J Korean Acad Rehab Med 2010; 34: 128-133)

Key Words: Tracheostomy, Videofluroscopic swallowing study (VFSS), Dysphagia, Stroke