ALS patient with tracheostomy tube

What is a Passy Muir Valve and How Can it Help ALS Patients?

There are many different symptoms associated with ALS and they each present their challenges for individuals diagnosed with the disease. Symptoms include difficulty swallowing, slurred speech and muscle weakness resulting in reduced mobility.

ALS is a neurodegenerative disease that is progressive, which means it gradually gets worse over time.

In the later stages of the disease, individuals will generally have breathing difficulties as the nerves that serve the respiratory muscles fail.

Here we take a closer look at the trouble ALS patients can have with breathing and how solutions such as a ventilator or tracheostomy may be needed to support them.

Breathing Difficulties in ALS Patients

The progression of ALS can vary quite considerably from person to person. Weakness in the areas of the body involved in the respiratory system will have incredibly huge consequences for the individual. Typically, these issues are more prevalent during the later stages of the disease.

These issues are often characterized by labored breathing and gasping with the individual having difficulty filling their lungs or expelling air.

This leads to other problems such as fatigue, which can mean, for example, that the individual is unable to walk long distances and they quickly become tired doing mundane, everyday activities.

Tracheostomy scar
Tracheostomy scar

As the impact on respiration worsens over time, the individual may not be able to breathe without some sort of aid. This is usually provided in the form of a tracheostomy, which involves making an incision into the throat area. A ventilator device is then inserted and used to fill and empty the lungs.

Passy Muir Valve

An operation such as a tracheostomy presents a number of issues and challenges for the patient. Whilst it eases breathing and aids respiration, it also prevents the patient from being able to swallow on their own and speak.

In a normal, healthy airway, breathing takes place through the mouth and nose. This is important for things like smell and taste but it also allows speech by letting air to pass over what is called the vocal folds.

As we swallow, a flap comes up to close off the airway and make sure that food or drink goes down the right channel and doesn’t end up in the lungs.

When a tracheostomy tube is introduced, the functioning of the airway is dramatically changed. In normal devices, this can cause issues such as necrosis and trauma to the airway. Because air isn’t passing over the vocal folds, patients can experience frustration and anxiety as they are unable to speak. The ability to smell and taste are also eliminated or at least greatly reduced.

The good news is that there have been great developments in this area in recent years. One such device is called the Passy Muir Valve.

The device was invented by David Muir, who was a muscular dystrophy patient at the time and it has helped transform care for those who require a tracheostomy. Essentially, when a procedure like this is performed, a cut is made in the throat and tube inserted.

A Passy Muir Valve fits onto this tube and helps redirect airflow so that it passes over the mouth, nose and vocal folds. What this means is that patients are able to communicate and swallow whilst the tube is still inserted.

The Benefits of the Passy Muir Valve

Clinical research undertaken since the device was invented has shown many benefits. For example, swallowing is easier with the Passy Muir Valve installed.

  • It’s also proved more successful in helping keep down infections and greatly improving the quality of life of those patients using it.
  • There’s evidence to suggest that it reduces the risk of aspiration. This is where food or liquid moves into the windpipe by mistake. Aspiration can cause choking and can also lead to infection.
  • A Passy Muir Valve can also help to restore a sense of smell and taste for individuals who use one, something that is often lost with other tracheostomy solutions.

The positive effects on saliva secretion management and swallowing are important for those with ALS. This is often a symptom of the disease in the later stages and can be made worse by the insertion of a breathing tube.

The swallowing action in healthy individuals involves a complex combination of muscles and nerves. With ALS, speaking and swallowing can be affected. As the nerves deteriorate and die off, these processes become more difficult and finally impossible.

A device such as the Passy Muir Valve enables individuals to maintain communication and improve their quality of life.