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Tracheostomy & Ventilator Swallowing and Speaking Valves

By: Beth Morrisey MLIS - Updated: 2 Jul 2010 | comments*Discuss
Tracheotomy tracheostomy

The general public is not usually familiar with tracheostomies or ventilators, particularly as they relate to speech and swallowing difficulties. This articles offers basic answers to some frequently asked questions about tracheostomies, ventilators, speech and swallowing difficulties and the aid of valves.

What Is A Tracheostomy?

A tracheostomy is the opening which result when a tracheotomy is performed to open a hole in the trachea (windpipe). This hole is known as a stoma. This hole may be temporary or permanent, and a tube will be inserted to allow for the passage of air and secretions. Once this tube is inserted, most people breath through it rather than their nose and/or mouth.

Why Would Someone Need A Tracheostomy?

There are many reasons that a tracheostomy may be needed, including problems with the airway, lungs, neuromuscular diseases/conditions and even loss of consciousness or coma. Severe burns to the area, vocal chord paralysis and injuries to the larynx (voicebox) may also result in the need for a tracheostomy.

What Is A Ventilator?

A ventilator is a machine that automatically moves air in and out of the lungs. This provides respiration (breathing) for individuals who are unable to effectively do this for themselves. Some individuals may use a ventilator with a nasal mask, however more serious cases require intubation via a tracheostomy. This allows a valve to be fitted so that air may be released through the one-way valve allowing the individual to exhale.

Why Would Someone Need A Ventilator?

Individuals require ventilators when they can not breath efficiently on their own. For some people this may mean wearing a mask while they sleep in order to breath more efficiently, while for others it may mean being intubated and connected to the ventilator at all times because they would be unable to breath for themselves otherwise.

How Is Speech Affected By tracheostomies and Ventilators?

Speech is most basically produced when air is pushed through the vocal chords and vibrates, resulting in sounds. When an individual has a tracheostomy and/or is intubated and connected to a ventilator, then some or all of the air is re-directed making the production of speech difficult or impossible. As a general rule of thumb, the more snugly the tube fits in the stoma, the less speech will be possible because the more air is taken away from the vocal chords. However, there are ways to work around the tube and produce speech. Covering the tube or using a one way tube that only allows air in, not out, will help individuals direct air through the vocal chords and produce sound.

How Is Swallowing Affected By tracheostomies and Ventilators?

Swallowing may be affected by tracheostomy and ventilator tubes, not the least because the different pressures from the trachea can lead to regurgitation of the swallowed materials. Smaller tracheostomies may present fewer difficulties for swallowing, though individuals should be monitored and suctioning provided if needed.

How Can Valves Help Speaking and Swallowing?

Valves, particularly one way valves, can help speaking and swallowing by providing individuals with a more natural approximation of the respiratory system by opening during inhale but closing during exhale. This means that air can be forced back through the vocal chords to create sound and also that some air will remain in the tube to protect against secretions such as materials that may be regurgitated after swallowing.

Where Can I Learn More About These Topics?

Passy Muir (www.passy-muir.com) is an industry leader in the design of tracheostomy and ventilator swallowing and speaking valves, though any medical or speech and language professional will be able to offer more information on these topics.

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I have multiple sclerosis and my voice is getting weaker. I am interested in amplifying my voice. I am inclined to think a contact microphone taped on to my neck might assist me in this. Does any one have any comments or ideas?
amc - 30-Dec-11 @ 10:55 AM
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