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CC BY 4.0 · Int Arch Otorhinolaryngol 2024; 28(01): e157-e164
DOI: 10.1055/s-0043-1767797
Original Research

Effect of Speaking Valves on Tracheostomy Decannulation

Bradley W. Eichar  
1   Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
,
Thomas M. Kaffenberger
1   Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
,
Jennifer L. McCoy 
2   Office of Research and Development, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States
,
Reema K. Padia
1   Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
2   Office of Research and Development, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States
,
Hiren Muzumdar
3   Division of Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
,
Allison B. J. Tobey
1   Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
2   Office of Research and Development, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States
› Author Affiliations Funding The author(s) received no financial support for the research.
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Abstract

Introduction Despite several pediatric tracheostomy decannulation protocols there remains tremendous variability in practice. The effect of tracheostomy capping on decannulation has been studied but the role of speaking valves (SVs) is unknown.

Objective Given the positive benefits SVs have on rehabilitation, we hypothesized that SVs would decrease time to tracheostomy decannulation. The purpose of the present study was to evaluate this in a subset of patients with chronic lung disease of prematurity (CLD).

Methods A retrospective chart review was performed at a tertiary care children's hospital. A total of 105 patients with tracheostomies and CLD were identified. Data collected included demographics, gestational age, congenital cardiac disease, airway surgeries, granulation tissue excisions, SV and capping trials, tracheitis episodes, and clinic visits. Statistics were performed with logistic and linear regression.

Results A total of 75 patients were included. The mean gestational age was 27 weeks (standard deviation [SD] = 3.6) and the average birthweight was 1.1 kg (SD = 0.6). The average age at tracheostomy was 122 days (SD = 63). A total of 70.7% of the patients underwent decannulation and the mean time to decannulation (TTD) was 37 months (SD = 19). A total of 77.3% of the patients had SVs. Those with an SV had a longer TTD compared to those without (52 versus 35 months; p = 0.008). Decannulation was increased by 2 months for every increase in the number of hospital presentations for tracheitis (p = 0.011).

Conclusion The present study is the first, to our knowledge, to assess the effect of SVs on tracheostomy decannulation in patients with CLD showing a longer TTD when SVs are used.

Keywords

tracheostomy - decannulation - speaking value - chronic lung disease - pediatric

The present work was presented virtually as a podium presentation at the American Academy of Otolaryngology- Head and Neck Surgery Conference from September 13- October 25, 2020.




Publication History

Received: 12 April 2022

Accepted: 05 December 2022

Article published online:
06 October 2023

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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