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Dysphagia management in tracheostomized patients: where are we now?

Lookup NU author(s): Diane Goff

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Abstract

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. PURPOSE OF REVIEW: Tracheostomized patients are medically complex and vulnerable. International attention is now focused on improving the safety and quality of their care. This review summarizes recent evidence in hot-topic areas pertinent to speech and language therapy (SLT) intervention for dysphagia management in tracheostomized patients. RECENT FINDINGS: The management of tracheostomized patients requires a truly multidisciplinary team (MDT) approach. Without this, patients remain tracheostomized and hospitalized for longer and have slower access to MDT members. Patterns of SLT intervention are variable across the United Kingdom, and further work to achieve consensus on best practice is required. Instrumental evaluation of swallowing provides vital information and can facilitate well tolerated oral feeding even prior to cuff deflation. A systematic review suggests that sensitivity of blue-dye testing is poor, but studies are methodologically flawed. The need for tracheostomy-specific quality of life measures is being addressed by the development of a questionnaire. SUMMARY: In this review, the main research themes relevant to speech and language therapists (SLTs) working with tracheostomized patients are discussed. This patient group poses significant challenges to robust study design. However, recent advances in uniting MDT members globally to improve standards of care are encouraging.


Publication metadata

Author(s): Goff D

Publication type: Article

Publication status: Published

Journal: Current Opinion in Otolaryngology and Head and Neck Surgery

Year: 2017

Volume: 25

Issue: 3

Pages: 217-222

Print publication date: 01/06/2017

Online publication date: 08/03/2017

Acceptance date: 02/04/2016

ISSN (print): 1068-9508

ISSN (electronic): 1531-6998

Publisher: Lippincott Williams and Wilkins

URL: https://doi.org/10.1097/MOO.0000000000000355

DOI: 10.1097/MOO.0000000000000355


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