Evaluation of the surgical closure of the larynx due to refractory aspiration pneumonia (Laryngo-tracheal separation, total laryngectomy, subglottic laryngeal closure)

Abstract

The surgical closure of the larynx due to refractory aspiration pneumonia is a very effective method for both the prevention of aspiration pneumonia and for allowing the patient to ingest food normally. This surgical procedure includes the laryngo-tracheal separation, a total laryngectomy, and subglottic laryngeal closure. We performing this surgery on 26 cases who were refractory to aspiration pneumonia, and their ages ranged from infants to adults. In all cases, the postoperative respiratory state was excellent. One case, which happened to be a severely retarded child (GM1 gangliosidosis case), developed pulmonitis. However, the pulmonitis was able to be managed successfully. In all adult cases, the normal ingestion of food became possible, and 71% of the cases were able to consume meals normally. As for the severely retarded they children, the swallow function had either decreased or had completely disappeared due to the effects of the primary disease. In conclusion, the surgical closure of the larynx is therefore considered to be a good treatment modality because it successfully obtained a steady respiratory state, and to some degree it made the ingestion of normal foods possible in these patients.