Effect of tracheotomy tube occlusion on upper esophageal sphincter and pharyngeal pressures in aspirating and nonaspirating patients

The biomechanics of the pharyngeal swallow in patients with a tracheotomy t ube were investigated with manometry. Upper esophageal sphincter (UES) and pharyngeal pressure recordings were made with and without occlusion of the tracheotomy tube. Criteria for selection were ability to tolerate tracheoto my tube occlusion for both 5 minutes prior to and during the first manometr ic analysis, absence of surgery to the upper aerodigestive tract other than tracheotomy, and no history of oropharyngeal cancer or stroke. Aspiration was determined objectively by fiberoptic endoscopic evaluation of swallowin g (FEES) immediately prior to manometric recording. Eleven adult individual s with tracheotomy participated; 7 swallowed successfully and 4 exhibited a spiration on FEES. The results indicated no significant effect of tracheoto my tube occlusion on UES or pharyngeal pressures in either aspirating or no naspirating patients. It was concluded that the biomechanics of the swallow as determined by UES and pharyngeal manometric pressure measurements were not changed significantly by tracheotomy tube occlusion in aspirating or no naspirating patients. These results support previous observations that subj ects either aspirated or swallowed successfully regardless of tracheotomy t ube occlusion status.