Secondary Voice Restoration After Laryngotracheal Separation (LTS) for Dysphagia with Intractable Aspiration

Objectives: Laryngeal dysfunction leading to incompetence and intractable aspiration can be a life-threatening problem. Laryngotracheal separation (LTS) can be used to prevent aspiration, but results in aphonia. The options for alaryngeal speech following LTS are limited. Methods: We performed tracheoesophageal puncture (TEP) and insertion of a Blom-Singer valve in 3 patients in an attempt to restore their voice after LTS for chronic aspiration. Results: Two patients had intractable aspiration (5 and 14 years) after full-course radiotherapy for laryngeal cancer, and 1 patient had aspiration after a stroke. In the first patient TEP was done as a secondary procedure, and in the other 2 patients it was done at the time of the LTS. The TEP was successful in providing these patients with phonation ability after their LTS procedure. There was no morbidity from these procedures. Conclusions: Creation of a TEP after an LTS procedure is relatively simple and relatively safe, and allows for the control of aspiration while maintaining vocal function.

Download Full-text

Clinical Outcome of Laryngotracheal Separation for Intractable Aspiration Pneumonia

ORL ◽

10.1159/000055766 ◽

2001 ◽

Vol 63 (5) ◽

pp. 321-324 ◽

Cited By ~ 18

Author(s):

Takayo Yamana ◽

Hiroya Kitano ◽

Masakazu Hanamitsu ◽

Kazutomo Kitajima

Keyword(s):

Clinical Outcome ◽

Aspiration Pneumonia ◽

Laryngotracheal Separation ◽

Intractable Aspiration

Download Full-text

Indications for the Tracheoesophageal Diversion Procedure and the Laryngotracheal Separation Procedure

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948809700507 ◽

1988 ◽

Vol 97 (5) ◽

pp. 471-475 ◽

Cited By ~ 51

Author(s):

David W. Eisele ◽

C. Thomas Yarington ◽

Roger C. Lindeman

Keyword(s):

Respiratory Tract ◽

Surgical Procedures ◽

Respiratory System ◽

Separation Procedure ◽

Upper Respiratory Tract ◽

Protective Function ◽

Laryngotracheal Separation ◽

Intractable Aspiration ◽

Upper Respiratory ◽

Surgical Separation

Impaired protective function of the larynx can lead to intractable aspiration, a severe and potentially fatal disorder. If medical therapy fails to prevent intractable aspiration, surgical separation of the upper respiratory tract from the digestive tract is necessary to prevent recurrent contamination of the respiratory system in these patients. Two such surgical procedures are the tracheoesophageal diversion procedure and the laryngotracheal separation procedure. Our approach to patients with intractable aspiration and the indications for the use of these surgical procedures for the prevention of aspiration are discussed.

Download Full-text

Tracheoesophageal Diversion and Laryngotracheal Separation Proceduresfor the Treatment of Intractable Aspiration in Young Patients.

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.47.463 ◽

1996 ◽

Vol 47 (5) ◽

pp. 463-468 ◽

Cited By ~ 2

Author(s):

Noboru Ogahara ◽

Ichirou Takamatsu ◽

Yuumi Kagesato ◽

Kiminao Ooishi

Keyword(s):

Young Patients ◽

Laryngotracheal Separation ◽

Intractable Aspiration

Download Full-text

The tracheoesophageal diversion and laryngotracheal separation procedures for treatment of intractable aspiration

The American Journal of Surgery ◽

10.1016/0002-9610(89)90534-5 ◽

1989 ◽

Vol 157 (2) ◽

pp. 230-236 ◽

Cited By ~ 50

Author(s):

David W. Eisele ◽

C.Thomas Yarington ◽

Roger C. Lindeman ◽

Wayne F. Larrabee

Keyword(s):

Laryngotracheal Separation ◽

Intractable Aspiration

Download Full-text

How I do it: Head and neck and plastic surgery: Laryngotracheal separation for intractable aspiration: A retrospective review of 34 patients

The Laryngoscope ◽

10.1288/00005537-199501000-00018 ◽

1995 ◽

Vol 105 (1) ◽

pp. 83-85 ◽

Cited By ~ 51

Author(s):

David E. Eibling ◽

Carl H. Snyderman ◽

Coleen Eibling

Keyword(s):

Head And Neck ◽

Plastic Surgery ◽

Retrospective Review ◽

Laryngotracheal Separation ◽

Intractable Aspiration

Download Full-text

Laryngotracheal Separation for Intractable Aspiration

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948809700506 ◽

1988 ◽

Vol 97 (5) ◽

pp. 466-470 ◽

Cited By ~ 34

Author(s):

Carl H. Snyderman ◽

Jonas T. Johnson

Keyword(s):

Tracheal Ring ◽

Effective Technique ◽

Recurrent Pneumonia ◽

Laryngeal Function ◽

Laryngeal Surgery ◽

Laryngotracheal Separation ◽

Neurologic Disorders ◽

Life Threatening ◽

Intractable Aspiration ◽

Laryngeal Anatomy

Intractable aspiration may be a life-threatening problem for patients with altered laryngeal function secondary to neurologic disorders or abnormal laryngeal anatomy. Multiple surgical procedures have been devised to deal with this problem. An effective technique involves the creation of a tracheostoma and closure of the larynx at the first or second tracheal ring. Laryngotracheal separation is relatively easy to perform and potentially reversible. Experience with this technique in six patients who required laryngeal separation for intractable aspiration is described. The procedure was successful in preventing aspiration and recurrent pneumonia associated with neurologic dysfunction, unresectable neoplasm, and conservation laryngeal surgery. One patient of one has had a successful reconstruction.

Download Full-text