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

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• 作者：Katrien Bonte ; Wouter Huvenne ; Marie De Loof ; Philippe Deron ; Annick Viaene…
• 关键词：Intractable aspiration ; Surgical management ; Laryngotracheal separation ; Deglutition ; Deglutition disorders
• 刊名：Dysphagia
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：30
• 期：6
• 页码：695-701
• 全文大小：545 KB
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• 作者单位：Katrien Bonte (1)
  Wouter Huvenne (1)
  Marie De Loof (1)
  Philippe Deron (1)
  Annick Viaene (2)
  Fr茅deric Duprez (3)
  Hubert Vermeersch (1)
  
  1. Department of Head, Neck & Maxillofacial Surgery, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
  2. Department of Physical Therapy and Motor Rehabilitation, Ghent University Hospital, Ghent, Belgium
  3. Department of Radiotherapy, Ghent University Hospital, Ghent, Belgium
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Otorhinolaryngology
  Imaging and Radiology
  Gastroenterology
  Hepatology
  
• 出版者：Springer New York
• ISSN：1432-0460

文摘

Intractable aspiration is a serious, often life-threatening condition due to its potential impact on pulmonary function. Aspiration requires therapeutic measures, starting with conservative management but often necessitating surgical treatment. The basic surgical principle is to separate the alimentary and respiratory tracts through a variety of procedures which, unfortunately, nearly all result in the loss of phonation, with the exception of total laryngectomy (TL) which includes the placement of an indwelling voice prosthesis. In this study, we present a modified laryngotracheal separation (LTS) technique that, we believe, offers multiple advantages compared to standard TL. After reviewing the medical records of 35 patients with intractable aspiration who have undergone LTS, we describe the surgical technique and present the postoperative result. In a second surgical procedure about two months following LTS, we aimed to achieve voice restoration by placement of an indwelling voice prosthesis. Intractable aspiration was successfully treated in all patients. Placement of an indwelling voice prosthesis during a second operation was successful in 15 patients, representing the largest reported cohort thus far. LTS is a reliable surgical technique to treat intractable aspiration, with restoration of oral intake, thereby improving the general condition and quality of life of these unfortunate patients. Furthermore, voice restoration can be achieved in selected patients, by placement of a voice prosthesis. Keywords Intractable aspiration Surgical management Laryngotracheal separation Deglutition Deglutition disorders