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Epiglottic position after cricothyroidotomy: a comparison with tracheotomy
J W Lim1, P K Lerner, S G Rothstein
1Department of Otolaryngology, New York University Medical Center, New York 10016, USA.
The Annals of Otology, Rhinology, and Laryngology
|July 1, 1997
Summary
Cricothyroidotomy significantly impairs swallowing function, increasing aspiration risk due to reduced epiglottic movement and laryngeal elevation. Normal swallowing function typically returns within two months after cricothyroidotomy tube removal.
Area of Science:
- Otolaryngology
- Swallowing Disorders
- Medical Devices
Background:
- Dysphagia is a common complication in patients with tracheotomy.
- The impact of cricothyroidotomy on swallowing function is not well understood.
Purpose of the Study:
- To evaluate dysphagia in patients undergoing cricothyroidotomy.
- To identify reliable indicators of swallowing dysfunction following cricothyroidotomy.
Main Methods:
- Retrospective chart review of modified barium swallow studies.
- Comparison of three patient groups: cricothyroidotomy, tracheotomy, and normal controls (8 patients each).
Main Results:
- Cricothyroidotomy patients exhibited greater impairment in epiglottic displacement, laryngeal elevation, and upper esophageal opening compared to tracheotomy patients.
- Impaired epiglottic displacement led to increased laryngeal penetration and aspiration risk in cricothyroidotomy patients.
- Normal epiglottic movement and swallowing function returned within two months post-cricothyroidotomy tube removal.
Conclusions:
- Cricothyroidotomy can cause significant swallowing dysfunction, primarily due to impaired epiglottic and laryngeal mobility.
- Tethering of the larynx at the cricothyroidotomy site restricts laryngeal elevation, impacting epiglottic function.
- Dysphagia following cricothyroidotomy is often reversible, with functional recovery observed within months of tube removal.