Surgical closure of the larynx for the treatment of intractable aspiration: Surgical technique and clinical results
Surgical closure of the larynx for the treatment of intractable aspiration: Surgical technique and clinical results
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DOI：
10.1002/lary.23306
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发表时间：
2012-06-01
期刊：
影响因子：
2.6
通讯作者：
Tayama, Niro
中科院分区：
文献类型：
--
作者：
Takano, Shingo;Goto, Takao;Tayama, Niro
目的/假设：喉外科闭合术（SCL）是一种防止牺牲发声功能的误吸的方法。本报告的目的是介绍我们的新手术方法，并对这些病例进行临床分析。研究设计：回顾性审查。方法：2003年至2011年，我们在两家机构使用我们的原始方法进行了32例手术闭合。我们分析了渗漏和其他并发症以及术前和术后的营养途径。结果：该方法的主要特点是减少了整个喉结构。为了减少喉部空间，我们切除了两侧的甲状软骨。在上皮瓣（假皱襞）和下皮瓣（声带）中集体缝合，无需插入铰链肌瓣。所有病例均未发生临床渗漏，术后完全预防了吸入性肺炎。大多数患者（56%）能够单独口服或结合管饲。结论：预防吸入性肺炎在医疗管理中非常重要，我们相信我们的方法提供了实现这一目标的良好手段。喉镜，2012年
Objectives/Hypothesis: Surgical closure of the larynx (SCL) is a method to prevent aspiration that sacrifices vocal function. The aim of this report was to introduce our new surgical method and perform clinical analysis of these cases. Study Design: Retrospective review. Methods: We performed 32 cases of surgical closure using our original method in two institutions from 2003 to 2011. We analyzed leakage and other complications and pre- and postoperative routes of nutrition. Results: The main feature of our method is reduction of the entire structure of the larynx. To reduce the laryngeal space, we excised both edges of the cut thyroid cartilage. Sutures were made collectively in upper flaps (false folds) and lower flaps (vocal folds), with no need for insertion of a hinged muscle flap. No clinical leakage was encountered in any cases, and aspiration pneumonia was completely prevented postoperatively. Most patients (56%) became able to ingest orally alone or in combination with tube feeding. Conclusions: Prevention of aspiration pneumonia is very important in medical management, and we believe that our method offers a good means by which to achieve this goal. Laryngoscope, 2012