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Original Article

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
Journal of the Korean Academy of Rehabilitation Medicine 2010;34(2):128-133.
Department of Rehabilitation Medicine, Seoul Veterans Hospital, Korea. yang7310@naver.com
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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)

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