Abstract
We have performed glottic closure as a surgical procedure for 35 patients (30 men, 5 women) who had suffered from recurrent aspiration pneumonia since 1985 to 1997. The diseases which caused their aspiration included cerebrovascular disease, degenerative disease, cerebral tumor, ischemic heart disease, myocarditis, tumor of the head and neck region, pulmonary emphysema, tuberculosis etc.
Of these 35 cases, 33 patients underwent the glottic closure initially, and 29 cases of the 33 were successful. In the remaining 4 cases, a leakage of saliva was detected after the operation. 3 of these 4 cases then underwent a total laryngectomy, and the last patient had a second glottic closure operation. Two of the 35 cases underwent epiglottic closure, but in both of these cases saliva leakage was detected. One patient underwent a total laryngectomy after all, and another had the glottic closure operation. Both follow-up operations were successful.
In all patients, the pneumonia was improved. 29 patients were discharged. 5 patients died in hospital, and 1 is still in hospital.
As a glottic closure operation, Montgomery method is widely used. In this method, the laminae of the thyroid cartilage are perforated and sutured with the opposite arytenoid cartilages, and the vocal cords are sutured to each other. However, we use a “simplified” Montgomery method, in which the laminae of the thyroid cartilage are not perforated, and both arytenoid cartilages, the vocal cords and the false cords are sutured to each other. We have achieved good results with this procedure.
