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[DYSPHAGIA] TBI and CSF leak
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Lana,
I'm no expert on pressure but unles your patient keeps his mouth and nose
closed I can't see how pressure would build up.
David M. Zirlen, M.S., C.C.C.
Speech-Language Pathologist
Waterbury Hospital
Waterbury, CT
Zirlen & Zirlen Speech Pathologist
Chester, CT
In a message dated 11/30/01 5:16:46 PM Eastern Standard Time,
lbenson@capefearvalley.com writes:
> Sorry if this is a little off topic.
> I have a 25 y/o male who was involved in a parachute accident one month
> ago. He has a severe traumatic brain injury with multiple comminuted
> (shattered like) fractures involving the clivus (sphenoid bone), sinuses,
> orbits, frontal and vertex of the skull. Per the CT report -pt has
> complete disruption of the floor of the anterior cranial fossa. He also
> has bilateral maxillary fractures( along with some lower extremity bones
> broken). He currently has a trach and we have been using the Passy Muir
> Speaking Valve. He tolerates it very well- over an hour at a time with O2
> sat remaining 97-100 with only mild decreased vocal intensity. He does
> cough intermittently with the speaking valve on (and off). They have
> recently diagnosed him as having a Cerebral Spinal Fluid (CSF) leak.
> Physical therapy reports drainage through his nose of CSF when they sit him
> up. He is currently NPO and likely his intermittent coughing is on the CSF
> and secretions. My question is- would the change in pressure with use of
> the Passy Muir Speaking Valve have a negative effect on his CSF leak. Is
> there any reason to hold use of the speaking valve?
> Thank you for any input you may have.
> Lana Shivak-Benson MS CCC-SLP
>
>
>
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<HTML><FONT FACE=arial,helvetica><FONT SIZE=2>Lana,
<BR>
<BR>I'm no expert on pressure but unles your patient keeps his mouth and nose closed I can't see how pressure would build up.
<BR>
<BR>David M. Zirlen, M.S., C.C.C.
<BR>Speech-Language Pathologist
<BR>Waterbury Hospital
<BR>Waterbury, CT
<BR>Zirlen & Zirlen Speech Pathologist
<BR>Chester, CT
<BR>
<BR>In a message dated 11/30/01 5:16:46 PM Eastern Standard Time, lbenson@capefearvalley.com writes:
<BR>
<BR>
<BR><BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">Sorry if this is a little off topic.
<BR>I have a 25 y/o male who was involved in a parachute accident one month ago. He has a severe traumatic brain injury with multiple comminuted (shattered like) fractures involving the clivus (sphenoid bone), sinuses, orbits, frontal and vertex of the skull. Per the CT report -pt has complete disruption of the floor of the anterior cranial fossa. He also has bilateral maxillary fractures( along with some lower extremity bones broken). He currently has a trach and we have been using the Passy Muir Speaking Valve. He tolerates it very well- over an hour at a time with O2 sat remaining 97-100 with only mild decreased vocal intensity. He does cough intermittently with the speaking valve on (and off). They have recently diagnosed him as having a Cerebral Spinal Fluid (CSF) leak. Physical therapy reports drainage through his nose of CSF when they sit him up. He is currently NPO and likely his intermittent coughing is on the CSF and secretions. My question is- would the change in pressure with use of the Passy Muir Speaking Valve have a negative effect on his CSF leak. Is there any reason to hold use of the speaking valve?
<BR>Thank you for any input you may have.
<BR>Lana Shivak-Benson MS CCC-SLP
<BR></FONT><FONT COLOR="#000000" SIZE=3 FAMILY="SANSSERIF" FACE="Arial" LANG="0">
<BR>
<BR></FONT><FONT COLOR="#000000" SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="0"></BLOCKQUOTE>
<BR>
<BR></FONT></HTML>
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