Clinical Research
Effects of the Passy-Muir speaking valve on tracheotomized patients′ swallowing function after brain damage
Han Xiaoxiao, Zhang Ke, Yang Qinglu, Meng Zhanao, Dou Zulin, Zhang Yaowen
Published 2020-01-25
Cite as Chin J Phys Med Rehabil, 2020,42(01): 24-28. DOI: 10.3760/cma.j.issn.0254-1424.2020.01.006
Abstract
ObjectiveTo investigate the effect of a Passy-Muir speaking valve (PMV) on the biomechanics of swallowing and on aspiration among persons tracheotomized after brain damage.
MethodsTwenty tracheotomized patients with aspiration after brain injury were selected and randomly divided into a non-PMV intervention group and a PMV intervention group, each of 10. Both groups were given routine swallowing training, while the PMV intervention group was additionally provided with a PMV and trained to use it. The treatment ended when the tracheal tube was removed or after 2 weeks. High-resolution manometry and videofluoroscopy were used to evaluate the maximum pressure in the velopharynx (VP-Max), the maximum post-deglutitive upper esophageal sphincter (UES) pressure (UES-Max) and Rosenbek penetration aspiration (PAS) scores for both groups before and after the treatment.
ResultsBefore the treatment there was no significant difference between the two groups in terms of average VP-Max, UES-Max or PAS score. After the treatment, the average VP-Max and UES-Max had increased significantly in both groups, and the average PAS score of the PMV intervention group had decreased significantly. There was a significant positive correlation between the increases in VP-Max and the decrease in PAS scores.
ConclusionInserting a PMV can improve velopharynx contraction and post-deglutitive UES among persons tracheotomized after a brain injury. The increase in maximum velopharynx pressure is positively correlated with decreases in aspiration.
Key words:
Tracheotomy; Aspiration; Passy-Muir speaking valve; Swallowing
Contributor Information
Han Xiaoxiao
The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; The Affiliated Bao′an Hospital of Southern Medical University, Shenzhen 518101, China
Zhang Ke
The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
Yang Qinglu
The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, China
Meng Zhanao
The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
Dou Zulin
The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
Zhang Yaowen
The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China