title: Improved Dysphagia After Decannulation of Tracheostomy in Patients With Brain Injuries.
abstract: OBJECTIVE
  To investigate improved dysphagia after the decannulation of a tracheostomy in patients with brain injuries.
  
  
  METHODS
  The subjects of this study are patients with brain injuries who were admitted to the Department of Rehabilitation Medicine in Myongji Hospital and who underwent a decannulation between 2012 and 2014. A video fluoroscopic swallowing study (VFSS) was performed in order to investigate whether the patients' dysphagia had improved. We measured the following 5 parameters: laryngeal elevation, pharyngeal transit time, post-swallow pharyngeal remnant, upper esophageal width, and semisolid aspiration. We analyzed the patients' results from VFSS performed one month before and one month after decannulation. All VFSS images were recorded using a camcorder running at 30 frames per second. An AutoCAD 2D screen was used to measure laryngeal elevation, post-swallow pharyngeal remnant, and upper esophageal width.
  
  
  RESULTS
  In this study, a number of dysphagia symptoms improved after decannulation. Laryngeal elevation, pharyngeal transit time, and semisolid aspiration showed no statistically significant differences (p>0.05), however after decannulation, the post-swallow pharyngeal remnant (pre 37.41%±24.80%, post 21.02%±11.75%; p<0.001) and upper esophageal width (pre 3.57±1.93 mm, post 4.53±2.05 mm; p<0.001) showed statistically significant differences.
  
  
  CONCLUSIONS
  When decannulation is performed on patients with brain injuries who do not require a ventilator and who are able to independently excrete sputum, improved esophageal dysphagia can be expected.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
authors.forename: Jung-Hwa
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
authors.forename: Jeong-Gyu
authors.initials: JG
authors.lastname: Yoon
authors.affiliation: Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
authors.forename: Jang-Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Physical Medicine and Rehabilitation, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
authors.forename: Sung Sik
authors.initials: SS
authors.lastname: Cho
keywords: Brain injuries; Dysphagia; Fluoroscopy; Tracheostomy; Upper esophageal sphincter