Abstract
Surgery is sometimes necessary in refractory cases of swallowing training for dysphagia. We performed tracheoesophageal diversion to prevent intractable aspiration in the following eighteen patients with degenerative neuron disease: eleven with amyotrophic lateral sclerosis and three with Parkinson's and other diseases. Tracheoesophageal anastomosis was chosen as the operation procedure in seven patients, laryngectomy in nine, and laryngectomy with a folded pharyngeal flap in two.
Most patients with ALS decided to undergo the operation due to the extreme distress resulting from the aspiration of saliva and liquid. On the other hand, in most other patients the operation was recommended due to repeated aspiration pneumonia. Seventeen patients are now postoperatively able to have any kind of solid and liquid diet.
The surgery for aspiration prevents aspiration pneumonia and reduces sputum, and moreover provides oral intake for a longer time. Therefore, tracheoesophageal diversion should be a highly beneficial procedure for patients with degenerative neuron diseases, resulting in an improvement in the patient's QOL.
