Laryngotracheal separation (LTS) is a surgical procedure for the treatment of intractable aspiration which separates the upper respiratory tract from the digestive tract.
We performed LTS in three pediatric patients with severe central nervous disorders, resulting in decreased hospitalization and nursing requirements. Considering the reliability and simplicity of the procedure, we prefer LTS to tracheoesophageal diversion, especially for pediatric patients. Pooling in the subglottic laryngotracheal blind pouch created in LTS has been thought to be a potential source of a tracheocutaneous fistula, however, practically, tracheocutaneous fistula is uncommon because changing of posture and swallowing clear the pooling in the blind pouch.
In pediatric patients, we consider the indication for LTS as follows: a patient with intractable aspiration, whose original disease is difficult to cure, and whose vocal dysfunction will be irreversible in the future.
