LARYNGOPALSTY

Abstract

Laryngoplasty ia a surgical technique for repairing of a defect or deformity and for restoring of function of the larynx. In this paper, the author dealt with the laryngoplasty performed on the laryngectomized patients, and discussed on the problems of postoperative aspiration of food or a salivary flow into the trachea. Out of 41 patients received Asai's method, 37 patients had the aspiration problems. Aspiration is one of the embarrassing problems after laryngoplasty and may have been a cause of pneumonia which is sometime fatal, and the author suggested that for the prevention of aspiration of food the patients must learn to press on the pharyngeal fistula externally on the anterior neck during food intake.
Aspiration of a flow of saliva into the trachea or the reflected swallowing of saliva through the pharyngeal fistula is another type of aspiration problems, but fortunately in the most cases an amount of salivary flow is unexcessive and it will be removed by a cough. The author investigated the tracheal mucous membrane in the patients with the pharyngeal fistula and found that aspiration of saliva into the trachea may have prevented driness of the mucous membrane of the respiratory tract.
In the author's series of laryngoplasty, two patients developed pneumonia possiblly due to aspiration of food or fluid. The followings are suggested as the postoperative regimen for the patients with laryngoplasty:
1. Regular check-up as done for the laryngectomized patient.
2. Give a full knowledge of aspiration problems to the patient, and instruct him how to apply a pressure on the anterior neck during food intake.
3. Prevention of pulmonary complication by X-ray study of regular interval
The author also stressed a necessity of development of a new technique in laryngo plasty for the protection of aspiration of food or saliva