2005 Fiscal Year Final Research Report Summary
Investigation of swallowing dysfunction in tracheostomy patients
| Project/Area Number |
16591716
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Kumamoto University |
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Principal Investigator |
SAMEJIMA Yasuhiro Kumamoto University, University Hospital, Assistant Professor, 医学部附属病院, 講師 (50206009)
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| Co-Investigator(Kenkyū-buntansha) |
YUMOTO Eiji Kumamoto University, Faculty of Medical and Pharmaceutical Sciences, Professor, 大学院・医学薬学研究部, 教授 (40116992)
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| Project Period (FY) |
2004 – 2005
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| Keywords | dysphagia / tracheostomy / subglottic pressure / videofluoroscopy / aspiration |
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| Research Abstract |
Aspiration was often observed in the tracheostomy patients. The pathophysiology of this aspiration is not well understood, but it is attributed to multiple factors including reduced laryngeal elevation, reduced cough, and disuse atrophy of laryngeal musculature. Subglottic air pressure seem to be important for protecting aspiration because of its reduction when tracheostomy tube was plugged. But subglottic pressure was not measured directly in tracheostomy patients. The purpose of this study was to ensure positive subglottic pressure while swallowing and its protective effect for aspiration.
Nine patients with tracheostomy suffering from head and neck cancers (7 patients), a cerebrovascular accident and a subglottic laryngitis were chosen for this study. These patients were able to plug their tracheostomy tube and to swallow saliva at this study. Subglottic pressure was measured through the tracheostomy tube with or without the plug. Videofluoroscopy was used to observe the penetration and/or aspiration under the same condition of the plug.
Subglottic pressure during swallowing was significantly higher in the measurement with the plug than without plug. The phonation and cough generated the higher pressure than swallowing. Videofluoroscopy revealed that aspiration was reduced (or eliminated) during swallowing when they plug the tube, when compared to swallowing with an open (unplugged) tube.
This study demonstrates the positive subglottic pressure while swallowing and decreased aspiration by plugging the tracheostomy tube.
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