Deglutitive aspiration in patients with tracheostomy: effect of tracheostomy on the duration of vocal cord closure. Gastroenterology 1995 May;108(5):1357-60
Date
05/01/1995Pubmed ID
7729626DOI
10.1016/0016-5085(95)90682-7Scopus ID
2-s2.0-0028957801 (requires institutional sign-in at Scopus site) 61 CitationsAbstract
BACKGROUND/AIMS: Deglutitive aspiration in patients with tracheostomy has been attributed to impaired laryngeal movement, loss of protective laryngeal reflexes, and uncoordinated laryngeal closure. The aim of this study was to determine the effect of tracheostomy on the duration of deglutitive vocal cord closure.
METHODS: Using concurrent videoendoscopy, respirography, and submental electromyography, deglutitive vocal cord closure and its temporal relationship with deglutitive apnea was compared between patients with tracheostomy and normal volunteers.
RESULTS: Between-group comparison showed that the duration of vocal cord adduction/abduction in patients with tracheostomy was significantly shorter than that of normal volunteers (P < 0.05). Contrary to normal volunteers, in patients with tracheostomy, 5-mL water swallows significantly increased the duration of vocal cord adduction/abduction compared with that of dry swallows (P < 0.05). In addition, in patients with tracheostomy, deglutitive apnea and submental electromyography were not coordinated with vocal cord kinetics.
CONCLUSIONS: Although the vocal cords close completely during swallowing in patients with tracheostomy, their duration of closure is significantly shorter compared with normal volunteers. Coordination of deglutitive vocal cord kinetics, apnea, and submental electromyography is altered in patients with tracheostomy. Contrary to normal controls, duration of deglutitive vocal cord closure in patients with tracheostomy is modified by the presence of liquid bolus.
Author List
Shaker R, Milbrath M, Ren J, Campbell B, Toohill R, Hogan WAuthors
Bruce H. Campbell MD Emeritus Professor in the Otolaryngology department at Medical College of WisconsinReza Shaker MD Assoc Provost, Sr Assoc Dean, Ctr Dir, Chief, Prof in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Apnea
Deglutition
Deglutition Disorders
Humans
Inhalation
Kinetics
Middle Aged
Time Factors
Tracheostomy
Vocal Cords