Airway interruption in encephalopathic children: a clinical and histological analysis.
Severe, incessant aspiration can be a most troublesome sequel to the already tragic problem of a vegetative mental state in a previously normal child. Three patients, aged 2 to 4 years, underwent surgery to treat their aspiration. A different type of procedure was used for each patient: cord closure combined with an epiglottic flap, cord closure alone, and a laryngeal stent. Laryngeal histopathology of a case is presented for the first time; findings suggest that the theoretical reversibility of that particular type of procedure could prove formidable. Clinically, the immediate cessation of aspiration has provided all parents and health care personnel with a surprising sense of gratification and has enabled each child to be transferred to a less-costly care facility or to home.
D002675:Child, Preschool; D003128:Coma / Q000150:complications* / Q000473:pathology; D004825:Epiglottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007817:Laryngeal Cartilages / Q000473:pathology / Q000601:surgery; D007828:Laryngoscopy; D007830:Larynx / Q000473:pathology / Q000601:surgery; D008297:Male; D011015:Pneumonia, Aspiration / Q000473:pathology / Q000601:surgery; D012137:Respiratory System / Q000601:surgery*; D013536:Suture Techniques; D014140:Tracheotomy; D014827:Vocal Cords / Q000473:pathology / Q000601:surgery