Impact of tracheostomy on swallowing performance in Duchenne muscular dystrophy

Nicolas Terzi, Hélène Prigent, Michèle Lejaille, Line Falaize, Djillali Annane, David Orlikowski, Frédéric Lofaso
2010 Neuromuscular Disorders  
Mechanical ventilation has improved survival in patients with Duchenne muscular dystrophy (DMD). Over time, these patients experience upper airway dysfunction, swallowing impairments, and dependency on the ventilator that may require invasive mechanical ventilation via a tracheostomy. Tracheostomy is traditionally believed to further impair swallowing. To evaluate the effect of tracheostomy on swallowing we assessed swallowing performance and breathing-swallowing interactions before and after
more » ... acheostomy in 7 consecutive wheelchair-bound DMD patients, aged 25±4 years; over a 4-year period. Chin electromyography, laryngeal motion, and inductive respiratory plethysmography recordings were obtained during swallowing of three water-bolus sizes in random order. The evaluations were done before and after tracheostomy. Piecemeal deglutition occurred in all patients over several breathing cycles. Half the swallows were followed by inspiration before tracheostomy. Total bolus swallowing time was significantly shorter (P=0.009) and the number of swallows per bolus significantly smaller (P=0.01) after than before tracheostomy. Invasive ventilation via a tracheostomy may improve swallowing. Abstract word count: 153 pour un maximum de 150
doi:10.1016/j.nmd.2010.05.009 pmid:20558065 fatcat:2iiypnsglvecxbwgynug5lsjlm