title: Surgical closure of the larynx for intractable aspiration, using double hinged flaps of the vocal folds and false vocal folds.
abstract: We report a new surgical procedure to treat intractable aspiration: closure of the larynx, using double hinged flaps of the vocal folds and false vocal folds. The anterosuperior portion of the thyroid cartilage is ablated. A small horizontal incision is made just above the anterior commissure and is continued posteriorly along the laryngeal ventricle; these incisions are continued across the posterior wall of the glottis. Incisions are made into the bilateral vocal folds and false vocal folds in order to create the hinged flaps. The glottis and the supraglottis are closed by approximating the bilateral vocal folds and false vocal folds hinged flaps. Superiorly or inferiorly based sternohyoid muscle pedicles are then inserted into the dead space between the approximated bilateral vocal folds and false vocal folds hinged flaps. The removed lamina of the thyroid cartilage is obliterated between both sternohyoid muscle flaps to enforce the closure of the larynx.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan. kimisato@oct-net.ne.jp
authors.forename: K
authors.initials: K
authors.lastname: Sato
authors.forename: T
authors.initials: T
authors.lastname: Nakashima
mesh_terms: D001044:Aphonia / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000601:surgery; D003680:Deglutition Disorders / Q000601:surgery*; D006801:Humans; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000601:surgery*; D013524:Surgical Flaps; D013957:Thyroid Cartilage / Q000601:surgery; D014139:Tracheostomy; D014827:Vocal Cords / Q000601:surgery*