title: Surgical closure of the larynx for the treatment of intractable aspiration: surgical technique and clinical results.
abstract: OBJECTIVE
  Surgical closure of the larynx (SCL) is a method to prevent aspiration that sacrifices vocal function. The aim of this report was to introduce our new surgical method and perform clinical analysis of these cases.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  We performed 32 cases of surgical closure using our original method in two institutions from 2003 to 2011. We analyzed leakage and other complications and pre- and postoperative routes of nutrition.
  
  
  RESULTS
  The main feature of our method is reduction of the entire structure of the larynx. To reduce the laryngeal space, we excised both edges of the cut thyroid cartilage. Sutures were made collectively in upper flaps (false folds) and lower flaps (vocal folds), with no need for insertion of a hinged muscle flap. No clinical leakage was encountered in any cases, and aspiration pneumonia was completely prevented postoperatively. Most patients (56%) became able to ingest orally alone or in combination with tube feeding.
  
  
  CONCLUSIONS
  Prevention of aspiration pneumonia is very important in medical management, and we believe that our method offers a good means by which to achieve this goal.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, National Center for Global Health and Medicine, Tokyo, Japan. stakano@hosp.ncgm.go.jp
authors.forename: Shingo
authors.initials: S
authors.lastname: Takano
authors.forename: Takao
authors.initials: T
authors.lastname: Goto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kabeya
authors.forename: Niro
authors.initials: N
authors.lastname: Tayama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007564:Japan; D058753:Laryngoplasty / Q000379:methods*; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control*; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D055815:Young Adult