Presence of a tracheotomy tube and aspiration status in early, postsurgical head and neck cancer patients.
Head Neck
; 27(9): 757-61, 2005 Sep.
Article
em En
| MEDLINE
| ID: mdl-16086412
ABSTRACT
BACKGROUND:
We sought to investigate the effects, if any, that the presence of a tracheotomy tube has on aspiration status in early, postsurgical head and neck cancer patients.METHODS:
Twenty-two consecutive adult, postoperative head and neck cancer patients were prospectively evaluated with fiberoptic endoscopic evaluation of swallowing (FEES) under three conditions (1) tracheotomy tube present, (2) tracheotomy tube removed and tracheostoma covered with gauze sponge; and (3) tracheotomy tube removed and tracheostoma left open and uncovered. For each condition, the endoscope was first inserted transnasally to determine aspiration status during FEES and then inserted through the tracheostoma to corroborate aspiration status by examining the distal trachea inferiorly to the carina. Three experienced examiners determined aspiration status under each condition and endoscope placement.RESULTS:
There was 100% agreement on aspiration status between FEES results and endoscopic examination through the tracheostoma. Specifically, 13 of 22 patients (59%) swallowed successfully and nine of 22 (41%) aspirated. There was also 100% agreement on aspiration status for tracheotomy tube present, decannulation and tracheostoma covered by gauze sponge, and decannulation and tracheostoma left open and uncovered.CONCLUSIONS:
Neither presence of a tracheotomy tube nor decannulation affected aspiration status in early, postsurgical head and neck cancer patients. The clinical impressions that a tracheotomy or tracheotomy tube increases aspiration risk or that decannulation results in improved swallowing function are not supported. Rather, need for a tracheotomy indicates comorbidities (eg, respiratory failure, trauma, stroke, advanced age, reduced functional reserve, and medications used to treat the critically ill) that by themselves predispose patients for dysphagia and aspiration.
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Base de dados:
MEDLINE
Assunto principal:
Período Pós-Operatório
/
Traqueotomia
/
Transtornos de Deglutição
/
Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Head Neck
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Estados Unidos