An examination of the effects of Passy-Muir Tracheostomy Speaking Valve placement on incidence and severity of aspiration in tracheostomized patients

The purpose of this study was to examine the effects of tracheostomy cuff deflation and Passy-Muir Tracheostomy Speaking Valve placement on the incidence and severity of aspiration. In addition, the effects of cuff deflation and Passy-Muir valve placement on durational swallow measures were examined. Fourteen non-ventilator dependent patients completed videofluoroscopic swallow studies (VFSS) under three conditions: 1) cuff inflated, 2) cuff deflated, and 3) Passy-Muir valve in place. Four additional patients with cuffless tracheostomy tubes completed VFSS with no cuff and with the Passy-Muir valve in place. The order in which each participant completed these conditions was randomized. Participants were given two 5-mL boluses of thin liquid and two 5-mL boluses of puree. All VFSS were analyzed by a judge who was blinded to the condition under which each swallow was completed. All swallows were analyzed for the presence or absence of penetration or aspiration, the timing of aspiration, if present, and the severity of penetration/aspiration based on an apoint penetration-aspiration scale (Rosenbek, Robbins, Roecker, Coyle, & Wood, 1996).