Hand-Held Device Improves Cough, Swallowing

In these patients, we had a significant change in inspiratory phase, the duration significantly decreased. The duration of the compression phase decreased. The duration of the expiratory phase rise time decreased. And with that duration of the expiratory phase rise time decreasing, we had an increase in our cough volume accelerating-an indirect measure of how effective cough is, Ms. Pitts said.

However, in an interview she added that it was not known whether these changes were clinically significant. We didn’t measure sputum production, so as a researcher I can’t say necessarily it was a clinically significant improvement, but it’s a statistically significant improvement, she said.

There was also a significant decrease in the penetration-aspiration scores, pre- to post-treatment, indicating that the treatment decreased the depth the material entered the airway during the swallow. Not only did training result in a safer swallow, but it also resulted in a more productive cough, she said.

Ms. Pitts speculated that a possible reason for improvement in swallowing is strengthening of the muscles that control the hyoid, something that is vital for the pharyngeal phase of the swallow. It is also possible there were changes in subglottic pressure during swallow. Researchers plan to continue investigations into swallow and cough functions and how the device may affect them.

Paul Castellanos, MD, Associate Professor of Otolaryngology at the University of Alabama at Birmingham, had not heard about the device until the presentation at COSM. I think this is very exciting work…particularly for patients who are not clearly in need of being made NPO or are taking things by mouth, but have an abnormal swallowing study, he said.

In his practice, he has many silent aspirators. I still allow them to eat, but I have not been able to do anything to really rehabilitate them, he said. This device just might be the key to help these patients.

©2008 The Triological Society