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

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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.

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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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Authors and Affiliations

  1. Otolaryngology, Head & Neck Surgery, Ltd., Naperville, Illinois

    Joseph Donzelli MD

  2. Department of Speech Language Pathology, Marianjoy Rehabilitation Hospital, Wheaton, Illinois, USA

    Susan Brady MS, CCC-SLP, Michele Wesling MA, CCC-SLP & Melissa Theisen MA, CCC-SLP

  3. Department of Speech Language Pathology, Marianjoy Rehabilitation Hospital, Research Coordinator Swallowing & Voice Center, 26 West 171 Roosevelt Road, Wheaton, EL, 60187, USA

    Susan Brady MS, CCC-SLP

Authors
  1. Joseph Donzelli MD
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  2. Susan Brady MS, CCC-SLP
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  3. Michele Wesling MA, CCC-SLP
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  4. Melissa Theisen MA, CCC-SLP
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Corresponding author

Correspondence to Susan Brady MS, CCC-SLP.

Additional information

Work for this project was completed at Marianjoy Rehabilitation Hospital, Wheaton, Illinois.

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Donzelli, J., Brady, S., Wesling, M. et al. Effects of the Removal of the Tracheotomy Tube on Swallowing During the Fiberoptic Endoscopic Exam of the Swallow (FEES). Dysphagia 20, 283–289 (2005). https://doi.org/10.1007/s00455-005-0027-8

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  • DOI: https://doi.org/10.1007/s00455-005-0027-8

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