OBJECTIVE: To investigate effects of tracheostomy tube on the movement of the hyoid bone and larynx during swallowing by quantitative analysis of videofluoroscopic swallowing study. METHOD: 19 adult stroke patients with tracheostomies, who met the criteria of decannulation participated. Serial videofluroscopic swallowing studies were done over 14 days before decannulation, within 24 hours before decannulation, within 24 hours after decannulation, and over 14 days after decannulation. The kinematic parameter such as pharyngeal transition time, stage transition duration, maximal hyoid bone movement, and maximal laryngeal prominence movement were obtained by 2-D quantitative analysis of videofluoroscopic swallowing study. RESULTS: Pharyngeal transition time and stage transition duration were not significantly changed all the time. The maximal hyoid bone movement and maximal laryngeal prominence just after decannulation were improved significantly compared to just before decannulation (p<0.05), especially on vertical movement. CONCLUSION: The hypothesis that a tracheostomy tube disturbs the hyoid bone and laryngeal movement during swallowing may be supported by this study.