12.2 - Non-Oral Feeding Methods + Surgical Options Flashcards
What are three different non-oral feeding methods?
NG tube
PEG tube
J-tube
What is an NG tube?
2
Nasogastric tube
It is passed through the nose and down through the nasopharynx and esophagus into the stomach
When is an NG tube chosen?
As a short term strategy
What is a PEG tube?
2
Percutaneous endoscopic gastrostomy
It bypass the mouth and esophagus and leads directly to the stomach
What sort of food is used with PEG tubes?
Special formula
What is a J-tube?
2
Percutaneous endoscopic jejunostomy tube (PEJ)
A soft, plastic tube placed through the skin of
abdomen into the midsection of the small intestine.
When is a J-tube utilized?
Stomach malfunction
What sort of food is used with J-Tubes?
Specialized, predigested formulas
What are the benefits of NG Tubes?
5
Easy insertion
No anesthesia is needed
Generally well tolerated
Good short nutrition
Does not prevent patient from eating normally
What are the risks of NG Tubes?
7
Can be uncomfortable
Visible tube
Can distends PES and UES
May promote reflux
May promote nasal ulceration
May promote sinusitis
May delay swallow
What are the benefits of PEG tubes?
5
Can be used long-term
Tube is not visible
Patient can eat with tube in place
Inserted under local anesthesia,
Generally well tolerated
What are the risks of PEG Tubes?
5
Requires surgical placement
Infection can occur
Tube may fall out
Can cause reflux
Diarrhea
What are the benefits of J-tubes?
3
May reduce reflux
Tube is not visible
Provides nutrition even if stomach not available
What are the risks of J-Tubes?
4
Requires surgical placement
Needs continuous drip feeding
Requires hospital visits if dislodged
Special formula may not be tolerated
What are the three most common reasons for placing a feeding tube?
Inability to sustain nutrition orally (even with safe swallow)
Recovery from a short-term acute medical problem requires sufficient calories
Patient aspirates during eating
What are two surgical methods to improve Glottal Closure?
Medialization thyroplasty
Injection of biomaterials
What are five surgical methods to improve Airway Protection?
Stents
Laryngotracheal separation
Laryngectomy
Tracheostomy tubes
Feeding tubes
What are three surgical methods to Improve UES Opening?
Dilation
Myotomy
Botox injections
What is Medicalization Thyroplasty?
2
Surgical technique where a small piece of plastic is place behind the VF
This moves the VF closer to midline allowing for easier adduction
Is general anesthesia required for Medicalization Thyroplasty?
No
How does the Injection of Biomaterials improve glottal closure?
They are injected directly into a weakened vocal fold to “bulk-up” the tissue to improve glottal closure.
Which surgical method is used for smaller gaps?
Which is used for larger ones?
Injection of biomaterials
Medialization thyroplasty
What is a Laryngeal Stent?
What does it require?
A laryngeal “plug” preventing material from entering the airway.
A tracheostomy because glottis is blocked.
What is Laryngotracheal Separation?
The trachea is surgically separated from the larynx
Are Laryngeal Stent and Laryngotracheal Separation permanent solutions?
Not usually
What is a Total Laryngectomy?
2
The complete removal of the entire larynx
Patient now breathes through a stoma.
Is a Total Laryngectomy a permanent solution?
What is a major benefit of this procedure?
Yes
It may allow the individual to ingest food and liquid safely
What is the goal of Tracheostomy & Feeding Tubes?
What is a risk of Trachs?
Protection of the airway
Tracheostomy tubes can further impair swallowing in some patients
What are the three goals of surgical interventions to improve UES opening?
Stretching
Cutting
Paralysis
What is Dilation?
When is it often used?
It stretching the lumen of the UES
If the UES is restricted due to scarring
What are risks of Dilation?
2
The tear may extend beyond esophageal tissue
The benefits are often temporary, requiring repeated procedures
What is Myotomy?
A surgical technique in which cuts the fibers of the cricopharyngeal muscle within the PES to separate them
How is Botox used to improve UES opening?
When should this procedure not be used?
It is injected into the muscles around the UES in order to paralyze and relaxing them
If patient has significant esophageal reflux
