Impact of Tracheal Tube on Swallowing in Post-Operative Head and Neck Cancer Patients: Scintigraphic Analysis.
Jacopo Galli, Maria Raffaella Marchese, Tiziana Di Cesare and 5 others
PMID 33278001WHAT IT FOUND
Most swallowing measures, including aspiration, were similar with and without a capped tracheal tube, except esophageal residue increased without the tube.
Key findings
01Aspiration percentage was 0 in 15 of 19 patients both with and without the tracheal tube, and did not differ in the remaining 4 patients.
02Most swallowing parameters did not differ significantly between the two scans, except esophageal retention index increased without the tube.
03The same 4 patients who aspirated with the tube also aspirated without it.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 19 patients were analysed, and the authors state that the small sample size prevents a strong conclusion about aspiration. The study excluded patients with poor cognition, poor general condition, total laryngectomy, inability to stand, neurological dysphagia, and patients unable to suck through a straw, so it does not apply to more severe swallowing impairment. The study did not use a control group, and all patients were tested first with the tube and then without it. Oropharyngoesophageal scintigraphy lacks detailed anatomy of the swallowing structures. The study tested only a small-diameter capped tube near discharge, so it does not show what happens with open tubes, larger tubes, or tubes with cuffs.
Declared interests
The only funder listed is Università Cattolica del Sacro Cuore.
The easy way to misread this
Do not read the similar aspiration rate as proof that tracheostomy tubes never affect swallowing. The sample was small and selected, and esophageal retention increased without the tube.