Swallowing and voice outcomes following airway reconstruction V1

• Research type

  Research Study

• Full title

  What are the changes in voice and swallowing outcomes of adults with airway stenosis pre- and post- reconstructive airway surgery?

• IRAS ID

  258401

• Contact name

  A McGregor

• Contact email

  a.mcgregor@imperial.ac.uk

• Sponsor organisation

  Joint Research Compliance Office, Imperial College London

• Clinicaltrials.gov Identifier

  researchregistry4322, Research Registry registration

• Duration of Study in the UK

  2 years, 6 months, 2 days

• Research summary

  Research Summary
  Airway stenosis is a narrowing of the windpipe between the throat and the lungs. We don’t always know why it happens but for some it might be in response to radiotherapy, being on a ventilator (breathing machine) for a long time or because of a childhood illness. People with this problem experience a range of distressing symptoms such as shortness of breath, wheeziness, a hoarse voice and swallowing difficulties. To help people’s breathlessness, a tube, called a tracheostomy, may be put in the throat. For more long-term solutions, patients come to specialist centres such as ours to have complex surgery to widen the windpipe. Importantly, this successfully improves people’s breathing. However, patients and Speech and Language Therapists (SLTs) have concerns that this surgery may not improve the voice and swallowing symptoms and indeed it might make them worse. As a SLT, I am interested in understanding the impact of this surgery on voice and swallowing symptoms and this is the focus of my research.

  I will measure patients’ ability to swallow and use their voice before they have surgery, two weeks and six months after surgery. The aim of this is to track what changes in voice and swallowing ability rather than rely on our suspicions. I will also find out if there is a link between voice and swallowing problems and the cause of the windpipe narrowing or the type of operation.
  I will use my results to answer the following questions:
  • What symptoms bother the patients?
  • Is our pathway of care the best it can be?
  • What impact does airway surgery have upon voice and swallowing?
  • What changes do our team need to make to improve things?
  • What other research needs to be done to help people with airway narrowing?

  Summary of Results
  Some adults have problems breathing because their airway is too narrow. This is caused by scarring or trauma and is called laryngotracheal stenosis (LTS). They often need specialist surgery to widen their airway. This helps their breathing. Patients with LTS told us that they wanted to improve their breathing but that having LTS and surgery affected other parts of their lives – in particular voice and swallowing.

  This study investigated voice and swallowing outcomes in adults with LTS before and after surgery. Twenty people participated in the study. All had surgery at the same specialist centre in London. Outcome measures looking at voice and swallowing were completed before surgery, two weeks after surgery and 4-6 months after surgery. These outcomes included patient questionnaires and structured assessment of voice and swallowing by speech and language therapists. The two main findings of the study were:
  • the voice and swallowing profile of every patient was very different
  • for some patients they have difficulties with voice and swallowing before surgery

  Unfortunately the number of patients in the study was not large enough to analyse the difference before and after the surgery.

  The findings have been helpful to the clinical team at the surgical centre to make sure that care pathways are always personalised based on the outcomes collected as part of patient clinical care.

• REC name

  London - Surrey Borders Research Ethics Committee

• REC reference

  19/LO/1007

• Date of REC Opinion

  25 Jun 2019

• REC opinion

  Favourable Opinion