Many patients reports changes in their swallowing following a tracheostomy. Although many patients swallow very well following a tracheostomy, there are several reasons why a change in swallowing may be noticed.
For this reason, should you notice any changes in your swallow ability, or begin coughing, choking during eating, it is extremely important to notify your doctor/SLP. Following an evaluation, the SLP staff be able to better manage your swallowing for the best function possible.
If at any time you notice food or drink material being coughed and expelled from the tracheostomy tube, you should always contact your doctor and/or SLP immediately. This may be an indication of a swallowing problem that could have very severe health implications.
For this reason, should you notice any changes in your swallow ability, or begin coughing, choking during eating, it is extremely important to notify your doctor/SLP. Following an evaluation, the SLP staff be able to better manage your swallowing for the best function possible.
If at any time you notice food or drink material being coughed and expelled from the tracheostomy tube, you should always contact your doctor and/or SLP immediately. This may be an indication of a swallowing problem that could have very severe health implications.
Subglottic Pressurization
The closing of the vocal cords also plays a very important role in the swallow process. By closing during the swallow, the vocal cords prevent any air from leaving the lungs during the swallow. This subglottic pressure is important for driving a strong swallow. For more information on how we swallow, see Normal Swallowing (link).
In a tracheostomy patient, even if the vocal cords adduct (close) as they should during the swallow, the typical subglottic pressurization is not achieved since the open tracheostomy tube is creating an opening for air to leave the lungs. As such, many patients may experience swallowing difficulty following their tracheostomy.
A Passy-Muir Speaking Valve (PMV) can be utilized to assist with swallowing difficulties when subglottic pressurization appears to be a contributing factor. For this reason, if you have been provided with a PMV, it is always recommended you are wearing the valve during meals, but also as often as possible, while awake, is ideal in this regard, as it will also help with the regular swallowing of saliva and other secretions throughout the day.
Hyolaryngeal Movement
During a normal swallow, the larynx (voice box), along with other attached muscles/structures, moves upward and outward. This is referred to as hyolaryngeal movement and can be observed when you watch or feel your Adam’s apple (thyroid cartilage) move up and down during a swallow.
In normal human anatomy, the larynx is attached to the trachea, through which the tracheostomy tube has been inserted and rests following a tracheostomy. In some cases, the tube can contribute to less hyolaryngeal movement as a result. Any changes in swallowing following a tracheostomy should always be reported to your doctor and/or SLP staff. Although the tracheostomy may not be contributing to any perceived swallowing problem, proper evaluation of the swallow function should be conducted to ensure the patient is eating as safely and effectively as possible.
