What is a common cause of swallowing problems in patients with tracheostomy?

• A. Limited elevation of the larynx
• B. Excessive epiglottis closure
• C. Hyperactive tongue
• D. Esophageal motility disorder

Answer: (A)

When swallowing, lifting (elevating) the larynx is crucial for airway protection and opening the esophagus. In patients with a tracheostomy, the tube and its cuff often restrict movement of the larynx and hyolaryngeal structures. This limited elevation means the airway doesn’t close as effectively and the larynx doesn’t rise and tilt forward as fully as it should during the swallow. As a result, material can more easily enter the airway, leading to swallowing problems and a higher risk of aspiration.

The other options don’t fit this common tracheostomy-related issue. Epiglottis closure that’s excessive would actually aid protection rather than cause trouble. A hyperactive tongue is typically an oral-phase issue and not specific to tracheostomy. An esophageal motility disorder concerns the esophagus rather than the protective mechanisms of the airway during the swallow.