Effect of the Passy-Muir Valve on aspiration in patients with tracheostomy.
OBJECTIVE
To assess potential benefit of a Passy-Muir Speaking Valve (PMV) in decreasing aspiration in patients with a tracheostomy.


BACKGROUND
Many patients with tracheostomy exhibit clinically significant aspiration. It has been previously noted that aspiration can often be reduced or eliminated by plugging or removing the tracheostomy tube. Some patients, however, do not tolerate removal or plugging of their tracheostomy tube, which then leads to persistent aspiration. We postulated that a one-way speaking valve may restore more normal subglottic and glottic air flow and reduce aspiration.


METHODS
Alert patients with a tracheostomy and clinical evidence of aspiration were eligible for study. Eleven patients with tracheostomy and known aspiration were studied with a modified barium swallow. Radiographic examination was used to evaluate the presence and amount of aspiration while patients swallowed both with and without a PMV in place on their tracheostomy tube.


RESULTS
Aspiration was reduced (or eliminated) during swallowing in all 11 patients when they wore a PMV, when compared to swallowing with an open (unvalved) tube. This improvement was achieved with liquids, semisolids, and pureed consistencies.


CONCLUSIONS
This study demonstrates that a Passy-Muir speaking valve facilitated swallow and reduced aspiration in patients with a tracheostomy and known aspiration.
Dettelbach
M A
MA
University of Pittsburgh School of Medicine, Department of Otolaryngology, PA 15213, USA.
Gross
R D
RD
Mahlmann
J
J
Eibling
D E
DE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001465:Barium Radioisotopes; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004867:Equipment Design; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D001239:Inhalation; D008297:Male; D008875:Middle Aged; D014139:Tracheostomy / Q000009:adverse effects* / Q000295:instrumentation*; D016896:Treatment Outcome
D001465:Barium Radioisotopes