Voice and swallowing concerns of adults with airway stenosis
Research type
Research Study
Full title
What are the voice and swallowing concerns of adults with airway stenosis who have had reconstructive airway surgery?
IRAS ID
249738
Contact name
Gemma Clunie
Contact email
Sponsor organisation
Joint Research Compliance Office, Imperial College London
Clinicaltrials.gov Identifier
researchregistry4322, Research Registry registration
Duration of Study in the UK
1 years, 6 months, 2 days
Research summary
Summary of Research
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 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 talked to patients with this condition who have already had surgery with us and they helped shape this project.
I will talk to small groups of patients about what they find difficult about living with airway stenosis, including their voice and swallowing problems. I will ask them what they think about the care they have received and the changes surgery has made to their lives.I will use my results to answer the following questions:
• What swallowing and voice symptoms bother the patients?
• Do swallowing and voice problems affect everyday life?
• What do patients want from the SLT team?
• How can we improve the SLT pathway of care?
• What impact does airway surgery have upon voice and swallowing?
• What other research needs to be done to help people with airway narrowing, particularly for swallowing and voice difficulties?Summary of Results
This study looked at the voice and swallowing concerns and outcomes of adults with laryngotracheal stenosis who undergo airway reconstruction. The research was driven by my clinical experience as an SLT working with this population, setting up a service and seeking evidence to guide the advice, support and interventions I was providing to patients. The patients themselves were also telling me and my colleagues that although their breathing was their priority there were other issues impacting their lives, including voice and swallowing changes, but the literature focuses on the changes to breathlessness.
The qualitative study used focus
groups and interviews to ask patients who had had reconstructive surgery at our centre about their lived experience of LTS with a focus on voice and swallowing.
The three overarching themes of the medical, physical and emotional journey showed that voice and swallowing concerns were interrelated within every aspect of a person with LTS’s lived experience but that participants wanted individualised management and information provision. Interestingly, LTS itself was often discussed as the cause of voice and swallowing concerns.The qualitative study also led to the development of the third piece of research within the PhD because of the challenges participants expressed relating to the management of mucus and cough. A survey was developed to investigate this issue in more detail. There was interplay between mucus, cough and voice and swallowing and participants indicated that mucus and cough affected all aspects of their lives. Despite this they also reported no consistent treatment advice or management.
REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
18/NE/0341
Date of REC Opinion
25 Oct 2018
REC opinion
Favourable Opinion