Epiglottic plication for intractable aspiration.
We describe a procedure to plicate the epiglottis into a vertical tube to prevent soiling of the airway due to intractable aspiration. The procedure is combined with an extensive cricopharyngeal myotomy. This technique allows laryngeal speech, even with a tracheostomy, and in some patients may allow the reversal of the tracheostomy. It is only suitable for a small proportion of patients with marked aspiration, as most will respond to conservative treatment. Nine patients underwent this operation and six gained a satisfactory result, with two patients achieving tracheostomy reversal. There were two late post-operative deaths from infective causes which reflects the general debilitation of these patients and the risk of exacerbating concomitant broncho-pulmonary infection.
Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, London, UK.
J P
JP
Harcourt
G B
GB
Brookes
D000328:Adult; D003680:Deglutition Disorders / Q000601:surgery*; D004825:Epiglottis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection