Aspiration treated by laryngeal closure in the subglottic area

Abstract

Many patients with severe dysphagia are male, the larynx has often dropped, and even tracheostomy is sometimes difficult. During surgery to prevent aspiration in such patients, techniques that can be performed even in the presence of a dropped larynx are necessary. In addition, since complications are generally present in such patients, minimally invasive surgical techniques are desirable. Therefore, we developed a laryngeal closure method in the subglottic area that prevents postoperative suture failure and can also be performed in patients with a dropped larynx. This surgical technique was performed in patients with severe dysphagia. The subjects comprised 5 patients who had undergone this procedure more than 6 months previously. All were males aged ≧70 years and had demonstrated repeated episodes of pneumonia. In this surgical technique, laryngeal closure is performed in the subglottic area, and the dead space formed in the suture area is filled with an anterior cervical muscle flap. The status of ingestion before and after surgery and the course were observed and evaluated. There were severe complications in any patients. In all patients, the prevention of aspiration was achieved, and the status of ingestion improved. This surgical procedure may be an accurate aspiration-preventive technique that is minimally invasive and infrequently induces suture failure.