KMID : 1140920170410030426
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Annals of Rehabilitation Medicine 2017 Volume.41 No. 3 p.426 ~ p.433
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Effects of Capping of the Tracheostomy Tube in Stroke Patients With Dysphagia
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Kim Yong-Kyun
Lee Sang-Heon Lee Jang-Won
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Abstract
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Objective: To investigate the impact of tracheostomy tube capping on swallowing physiology in stroke patients with dysphagia via videofluoroscopic swallowing study (VFSS).
Methods: This study was conducted as a prospective study that involved 30 stroke patients. Then, 4 mL semisolid swallowing was conducted with capping of the tracheostomy tube or without capping of the tracheostomy tube. The following five parameters were measured: laryngeal elevation, pharyngeal transit time, post-swallow pharyngeal remnant, upper esophageal sphincter width (UES), and penetration-aspiration scale (PAS) score.
Results: On assessment of the differences in swallowing parameters during swallowing between ¡®with capping¡¯ and ¡®without capping¡¯ statuses, statistically significant differences were found in the post-swallow pharyngeal remnant (without capping, 48.19%¡¾28.70%; with capping, 25.09%¡¾19.23%; p<0.001), normalized residue ratio scale for the valleculae (without capping, 0.17¡¾0.12; with capping, 0.09¡¾0.12; p=0.013), normalized residue ratio scale for the piriform sinus (without capping, 0.16¡¾0.12; with capping, 0.10¡¾0.07; p=0.015), and UES width (without capping, 3.32¡¾1.61 mm; with capping, 4.61¡¾1.95 mm; p=0.003). However, there were no statistically significant differences in laryngeal elevation (x-axis without capping, 2.48¡¾1.45 mm; with capping, 3.26¡¾2.37 mm; y-axis without capping, 11.11¡¾5.24 mm; with capping, 12.64¡¾6.16 mm), pharyngeal transit time (without capping, 9.19¡¾ 10.14 s; with capping, 9.09¡¾10.21 s), and PAS score (without capping, 4.94¡¾2.83; with capping, 4.18¡¾2.24).
Conclusion: Tracheostomy tube capping is a useful way to reduce post-swallow remnants and it can be considered an alternative method for alleviating dysphagia in stroke patients who can tolerate tracheostomy tube capping when post-swallow remnants are observed.
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KEYWORD
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Tracheostomy, Stroke, Deglutition disorders, Fluoroscopy
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