title: [Surgical management for intractable aspiration in handicapped children].
abstract: 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.
authors.affiliation: Department of Pediatrics, Hokkaido Asahikawa Habilitation Center for Disabled Children, Asahikawa, Hokkaido. akiem@potato4.hokkai.net
authors.forename: Akie
authors.initials: A
authors.lastname: Miyamoto
authors.forename: Ayumi
authors.initials: A
authors.lastname: Kitahata
authors.forename: Ikue
authors.initials: I
authors.lastname: Fukuda
authors.forename: Ryuji
authors.initials: R
authors.lastname: Oka
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Cho
authors.forename: Hajime
authors.initials: H
authors.lastname: Tanaka
mesh_terms: 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