We experienced 21 patients who were administered surgical procedures to prevent aspiration in the Otolaryngology Department of the National Defense Medical College Hospital between January 1989 and March 1999. Details are as follows; 5 cases of Lindeman's tracheo-esophageal anastomosis; 2 cases of Lindemasn's laryngo-tracheal diversion; 1 case of Habal-Murray's laryngeal closure (epiglottis and aryepiglottic fold suture procedure; 7 cases of glottal closure, and 6 cases of closure of the false vocal folds. The surgical procedure had to be frequently restricted for each case according to the location of the tracheostoma, the etiology and prognosis of dysphagia, the condition of daily care, and other factors. However, to select a specific method we followed the principle that we should begin with explanation to the patient and his/her family about the available methods to prevent aspiration, as well as their expected outcomes. Then, the method chosen by the patient and his/her family was re-confirmed by the clinician.
