Abstract
The presence of endotracheal or tracheostomy tube disrupts the normal physiology of swallowing. The most frequently related abnormal mechanical factors are delayed triggering of the swallowing response, reduced laryngeal elevation, reduced cough due to “desensitization” of larynx and reduced subglottic pressure. These abnormalities lead to delay in oral feeding and even aspiration pneumonia. The transglottic airflow has to be restored as soon as the patient does not need ventilation. But the difficulties of introduction of oral feeding can also be due to age, concomitant disease (e.g. COPD, neurologic diseases) or critical illness polyneuropathy. Fiberoptic endoscopic evaluation of swallowing allows an accurate diagnosis of swallowing disorders to provide safe swallow and avoid aspiration pneumonia.
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