Abstract
Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease. Management of aspiration is most important in the lates stages of ALS. Total laryngectomy completely separates the airway from the food passage, but is not often performed because of permanent loss of vocal function, and psychological damage due to loss of the larynx. We have experienced five cases of total laryngectomy in ALS patients. All of these patients were able to eat orally and were discharged with favorable progress within a few weeks after total laryngectomy. The quality of life of both the patients and their families improved significantly after surgery. Although total laryngectomy for the management of aspiration in ALS patients is still under discussion, it can be a desirable surgical procedure. If the patient and his/her family understand the nature of the disease and the importance of the social environment surrounding the patient and if patient psychological problems can be resolved, total laryngectomy should be more aggressively performed.
