[Surgical rehabilitation of neuromuscular swallowing disorders with special regard to cricopharyngeal myotomy and glottopexy].
Surgical Rehabilitation of Neuromuscular Swallowing Disorders with Special Regard to Cricopharyngeal Myotomy and Glottopexy.


BACKGROUND
The surgical rehabilitation of patients with swallowing disorders caused by neuromuscular insufficiency with life-threatening aspiration presents a special challenge to the ENT-surgeon.


METHODS
In a period of 5 years we decided on a surgical treatment in altogether 12 patients with paralytical dysphagia. In 6 patients we combined a cricopharyngeal myotomy with a complete closure of the glottis, in 5 patients we performed a sole cricopharyngeal myotomy. In another patient we restricted ourselves to glottopexy only.


RESULTS
In all cases the dysphagia giving rise to the surgical intervention was regredient so far that the removal of the percutan endoscopic gastrostomy postsurgically was possible. 3 special cases are presented in detail.


CONCLUSIONS
The main part of the therapy is the subtle and complete cricopharyngeal myotomy. Particulary good results are available with a combination of the latter with a reversible glottopexy.


CONCLUSIONS
After the failure of conservative therapy the indication for a surgical treatment should be made on a large scale.
Linke
R
R
HNO-Klinik und Poliklinik der Charité, Humboldt-Universität Berlin, Germany. robert.linke@t-online.de
Bockmühl
U
U
Haake
K
K
D000328:Adult; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D005774:Gastrostomy; D005931:Glottis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010243:Paralysis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D010348:Patient Care Team; D010528:Peristalsis / Q000502:physiology; D010609:Pharyngeal Muscles / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography