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Tracheostomy Swallow Clinic

What is a tracheostomy?

A tracheostomy is a surgical opening in the neck to place a tube into the windpipe. It allows breathing through the tube, bypassing the mouth and nose. A tracheostomy is required when a person is unable to breathe adequately due to a medical condition or a blocked airway. It can be removed when the doctor deems that it is no longer needed to support the person’s breathing. 

Patients with tracheostomy tubes inserted often have swallowing and communication difficulties, as the creation of an artificial airway causes alteration to the normal airway physiology for swallowing and speaking. In addition, many such patients have multiples medical conditions, that also put them at higher risk of having swallowing difficulties (or dysphagia).  

Speech Therapists can help manage swallowing and communication for these patients with tracheostomies.

How is speech and communication impacted and how can a Speech Therapist help?

Normally when we talk, air moves from the lungs through the vocal folds. The air makes the vocal folds vibrate to produce sound that comes out of your mouth. However, you cannot speak this way if you have a tracheostomy. With a tracheostomy, air goes through the opening in your neck and not through the vocal folds. You may find it difficult or even impossible to speak while on a tracheostomy tube. 

Being able to communicate with your family and the medical team is important. The breakdown in communication is frustrating not just for you, but for everyone who interacts with you.

The Speech Therapist can help you improve your communication function, while keeping your breathing needs as utmost priority. We will work with various medical professionals to find ways for you to speak, such as using a speaking valve or an electrolarynx, and using techniques such as ventilator leak speech. 

In the event that speaking is not possible, your therapist may suggest non-verbal methods such as writing, pointing to pictures on a board, using eye-movements to activate spelling.

How is swallowing impacted and how can a Speech Therapist help?

Some patients who are reliant on tracheostomy tubes may have varying levels of dysphagia. Speech Therapists can help you take steps towards managing your own saliva secretions independently. They can help you find ways to eat and drink safely. This may include eating different types of food or swallowing in different ways. They can also work with you to improve your swallowing via rehabilitation exercises.

How can I obtain an appointment to see the Speech Therapist? 

While you are warded

Your doctor may refer you to a Speech Therapist at an appropriate time during your admission. The therapist will assess your swallowing and communication abilities and make the necessary recommendations.

Speech Therapists are also part of SGH’s multi-disciplinary tracheostomy team, led by the Department of Respiratory and Critical Care Medicine. The tracheostomy team makes recommendations in consultation with the primary team towards weaning patients off the tracheostomy. The team also provides specialised tracheostomy care and education to nursing staff and caregivers.

After discharge from SGH

Your Speech Therapist will make an appointment for you to visit the Outpatient Speech Therapy Tracheostomy Swallow Clinic, should you still require a review for your swallowing or communication functions. 

For external referrals, please obtain a referral letter from a Singapore-registered medical doctor, made out to Speech Therapy. Please call SGH Central Appointment’s Hotline at 63214377 to make an appointment.