Speech Therapy for Tracheostomy
What is Tracheostomy?
We breathe in from our nose. Air passes through the windpipe (trachea). It reaches the lungs. If there is a blockage, or trachea is damaged it will lead to breathing difficulties. In such cases, a hole is made called a stoma. it is just below the vocal cords. This surgical procedure of creating the stoma and inserting a tube is called a tracheostomy. This can be permanent or temporary. The patient breathes in and out through the stoma.
Why do we get tracheostomy?
Tracheostomy is done on adults and children. Given below are some reasons for the same.
- Birth defects
- Chronic lung disease
- Diaphragm dysfunction
- Obstructive sleep apnea
- Vocal cord paralysis
There are many reasons for a tracheostomy. Bottom line, there is a blockage in the airway. It is not removable.
Why do we need Speech Therapy?
The air which we breathe out. It passes through the vocal cord. It vibrates them. This is how we produce sound. Tracheostomy hampers in the natural way of producing voice. As we are breathing in and out from stoma. Young children and adults will not be able to produce sound and communicate. Vocal cords and epiglottis prevent food from entering the airway. They protect the airway. Tracheostomy affects this. There can be other indications of swallowing problems. Loss of taste and smell of food, coughing and excessive secretions during or after eating. There can be sign of food in secretions. Gurgly voice post-meal shows the presence of food in the tube. Because of communication, voice, and swallowing issues, speech therapy is a must in patients with tracheostomy.
What does a speech therapist do?
The speech therapist takes part in the assessment, management, and decision-making process of patients with tracheostomy. First is communicating basic needs. If the patient is unable to communicate, it makes them frustrated. In the case of children, tantrums can be seen. The SLP suggests communication boards, apps and pictures. Patients will point and communicate, or use written format (if they can write).
Secondly, SLP helps in the decision-making process of fitting a speaking valve as well as aids you in speaking with it. The speaking valve will push the air through the vocal cord and help you produce sound. Voice produced through the speaking valve may be hoarse and will depend on whether or not there is underlying vocal cord pathology. In addition to this, SLP will also assist you in swallowing safely and in saliva management. They will be suggesting you to go for a formal swallow evaluation such as Video-fluoroscopy so as to evaluate whether you are ready for oral intake or not. SLP will provide you with safe swallow guidelines and suggest strengthening exercises for muscles involved in swallowing in the form of swallowing maneuvers. After that, we will also suggest alternatives which include eating different types of consistencies.
In conclusion, to know more about tracheostomy and speaking valve please watch the following video:
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