title: Physiologic effects of open and closed tracheostomy tubes on the pharyngeal swallow.
abstract: Studies linking aspiration and dysphagia to an open tracheostomy tube exemplify the possibility that the larynx may have an influence on oropharyngeal swallow function. Experiments addressing the effects of tracheostomy tube occlusion during the swallow have looked at the presence and severity of aspiration, but few have included measurements that capture the changes in swallowing physiology. Also, hypotheses for the importance of near-normal subglottic air pressure during the swallow have not been offered to date. As such, the aim of this study was to compare the depth of laryngeal penetration, bolus speed, and duration of pharyngeal muscle contraction during the swallow in individuals with tracheostomy tubes while their tubes were open and closed. The results of this series of experiments indicate that within the same tracheostomized patient, pharyngeal swallowing physiology is measurably different in the absence of subglottic air pressure (open tube) as compared to the closed tube condition.
authors.affiliation: Department of Audiology and Speech Pathology, Veterans Administration Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15240, USA.
authors.forename: Roxann Diez
authors.initials: RD
authors.lastname: Gross
authors.forename: Jeanne
authors.initials: J
authors.lastname: Mahlmann
authors.forename: Judith P
authors.initials: JP
authors.lastname: Grayhack
mesh_terms: D000368:Aged; D000399:Air Pressure; D001696:Biomechanical Phenomena; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology*; D004868:Equipment Failure; D005471:Fluoroscopy; D005931:Glottis / Q000502:physiology / Q000503:physiopathology; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D008297:Male; D008465:Mechanoreceptors / Q000502:physiology / Q000503:physiopathology; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D015588:Observer Variation; D009960:Oropharynx / Q000502:physiology* / Q000503:physiopathology; D010609:Pharyngeal Muscles / Q000502:physiology / Q000503:physiopathology; D013997:Time Factors; D014139:Tracheostomy / Q000009:adverse effects* / Q000295:instrumentation; D014743:Videotape Recording