Investigating dysphagia therapy in adults with a tracheostomy: a scoping review

There is limited information about dysphagia therapy for adults with dysphagia and tracheostomy tube (TT). We describe current empirical evidence to guide clinical practice and facilitate future discussions. We conducted a scoping review to identify methodological features of dysphagia therapy in adults with a TT. Ten electronic databases from inception to November 2024 were searched. Based on inclusion criteria, 24 studies were analysed. The papers were divided into therapy approaches: (i) oral phase (ii) oropharyngeal phase (iii) oropharyngeal and respiratory phase iv) pharyngeal phase and v) respiratory phase and were reported against the adapted version of the <i>Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide</i> [1]. Seven papers reported on pharyngeal electrical stimulation (PES) which showed statistically significant results for decannulation, whilst nine studies used multiple dysphagia therapy interventions without clear distinctions in methodological approach. Outcome measures are varied and limited in use. Various dysphagia therapies have been described for use in patients with TT but outside of PES, it is challenging to draw conclusions on the effect of specific dysphagia therapies on swallowing outcomes. More research is required to establish standardised protocols and outcome measures. This scoping review highlights the variety of dysphagia therapies available for adults with tracheostomies. Pharyngeal electrical stimulation is a prominent therapy technique used to support decannulation A respiratory intervention approach is an emerging therapy technique in this population Dysphagia interventions for adults with a tracheostomy are multimodal and will involve both motor and sensory therapy techniques Use of consistent standardised outcome measures will support identifying improvement in dysphagia pathophysiology for adults with a tracheostomy