PRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 10 October 2007
Clinical Study of 26 Cases of Laryngo-Tracheal
Separation/Diversion for Intractable Aspiration
Suguru Matsumoto, Tomoyuki Haji, Haruto Ikeda,
Shinichi Sato, Tetsuya Tamura and Kazuyuki Ozawa
(Kurashiki Central Hospital)
Atsushi Suehiro
(Kyoto University)
Laryngo-tracheal separation or tracho-esophageal diversion (original Lindeman's method and our modified method) was applied in 26 patients with intractable aspiration in Kurashiki Central Hospital from September 1997 to February 2005. We evaluated the surgical results based on patient satisfaction. Surgery decreased the frequency of sputum suction in most of the patients, and prevented the incidence of aspiration pneumonia in all patients. In 12 of 18 patients every meal was cleared orally without difficulty following the surgery. Individual swallowing potency and level of consciousness significantly affected post-operative oral food intake. Minor postoperative complications such as fistula at the proximal tracheal edge occurred in 6 patients. Most of the problems could be controlled by conservative therapy or minor revision surgery. There was no difference between the outcomes of separation surgery and diversion surgery in this series. We concluded that laryngo-tracheal separation/diversion surgery definitely benefited the quality of life for the patients with intractable aspiration as well as their families.
Key words : laryngo-tracheal separation, tracho-esophageal diversion, modified separation/diversion surgery, aspiration pneumonia,
quality of life (QOL)