[Surgical management for intractable aspiration in handicapped children].
Intractable aspiration is a life-threatening medical problem. Sixteen patients with intractable aspiration underwent surgical management. Their underlying diseases were cerebral palsy (n = 6), degenerative diseases (n = 5), acquired hypoxic ischemic encephalopathy (n = 4), and congenital myopathy (n = 1). Laryngotracheal separation was performed in nine patients with median age of 2 years 6 months (range: 7 mo - 13 y 5 mo), and laryngectomy was performed in seven with median age of 7 years 4 month (range: 1 y 6 mo - 17 y 1 mo). Surgical interventions were effective in all patients with respiratory distress. The most common complication was increased drawling in six patients, who recovered within 6 months of clinical follow-up. Other complications were tracheal granulations (n = 4), bleeding (n = 2), narrowing of the tracheal hole (n = 2), tracheomalacia (n = 2), ruptured suture (n = 1), and tracheal abscess (n = 1). Considering the underlying diseases and age, surgical management for intractable aspiration should be performed at appropriate timing.
Miyamoto
Akie
A
Department of Pediatrics, Hokkaido Asahikawa Habilitation Center for Disabled Children, Asahikawa, Hokkaido. akiem@potato4.hokkai.net
Kitahata
Ayumi
A
Fukuda
Ikue
I
Oka
Ryuji
R
Cho
Kazuhiko
K
Tanaka
Hajime
H
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities; D006801:Humans; D007223:Infant; D007825:Laryngectomy; D007830:Larynx / Q000601:surgery; D009468:Neuromuscular Diseases / Q000150:complications; D053120:Respiratory Aspiration / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D012720:Severity of Illness Index; D014132:Trachea / Q000601:surgery; D016896:Treatment Outcome