Laryngorhinootologie 2017; 96(05): 280-292
DOI: 10.1055/s-0043-103279
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Schluckstörungen bei tracheo(s)tomierten Patienten

Swallowing Disorders in Tracheo(s)tomized Patients
Carl-Albert Bader
1   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar
,
Annerose Keilmann
2   Stimmheilzentrum Bad Rappenau, Bad Rappenau
› Author Affiliations
Further Information

Publication History

eingereicht 30 January 2017

akzeptiert 31 January 2017

Publication Date:
17 May 2017 (online)

Zusammenfassung

Hintergrund Seit vielen Jahren sind in der Fachliteratur Hinweise zu finden, wonach bei tracheo(s)tomierten Patienten mit Schluckstörungen zu rechnen ist, deren schwerwiegendster Aspekt die Aspiration darstellt. Die vorliegende Arbeit soll einen aktuellen Beitrag zur Diskussion leisten, ob ein Tracheostoma eine Dysphagie verursacht oder verstärkt oder lediglich eine zeitliche Koinzidenz vorliegt.

Material und Methoden Die Übersichtsarbeit beruht auf einer Recherche in der textbasierten Datenbank PubMed des National Center for Biotechnology Information (NCBI).

Ergebnisse Es wurden die Effekte einer Tracheotomie/Tracheostomie sowie die Effekte einzelner Kanülentypen auf motorische und sensorische Aspekte des Schluckvorgangs geprüft. Die erfassten Studien fokussieren dabei in besonderer Weise die Aspirationshäufigkeit und zeigen eine insgesamt uneinheitliche Datenlage, welche keine zwingenden Beweise für eine eindeutige und kausale Beziehung zwischen dem Vorhandensein eines Tracheostomas und einer schweren Beeinträchtigung des Schluckens erkennen lassen.

Schlussfolgerungen Patienten mit einem Tracheostoma bedürfen ohne Zweifel einer besonderen Aufmerksamkeit im Hinblick auf das Vorhandensein relevanter Schluckstörungen. Diese sind aber möglicherweise eher einer schweren Grunderkrankung geschuldet als dem Vorhandensein des Tracheostomas per se.

Abstract

Objective Since many years it has been conjectured that tracheotomy/tracheostomy interferes with swallowing and leads to a higher risk of aspiration. The aim of this review was to contribute to the discussion whether there is a causal relationship between tracheotomy/tracheostomy and dysphagia or only a chronological concomitance.

Material and Methods Citations for this review rest upon a research in PubMed data base of the National Center for Biotechnology Information (NCBI).

Results Effects of tracheostomy/tracheotomy as well as effects of different cannulas on motoric and sensory aspects of deglutition have been reviewed. Most papers focused on aspiration. Reported data were extremely heterogeneous. Finally no causal relationship between tracheotomy and dysphagia could be demonstrated.

Conclusions Tracheo(s)tomized patients require a special awareness in respect to concomitant dysphagia. However, swallowing problems are considered to be primarily caused rather by underlying diseases than by the existence of the tracheostomy itself.

 
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