title: Central-part laryngectomy is a useful and less invasive surgical procedure for resolution of intractable aspiration.
abstract: A novel narrow-field laryngectomy procedure known as central-part laryngectomy (CPL) for less invasive laryngeal diversion in patients with intractable aspiration is introduced. We conducted retrospective case reviews of 15 patients who underwent CPL. In this procedure, an area of the glottis including the mid-part of the thyroid cartilage and cricoid cartilage is removed to separate the digestive tract from the air way. The lateral part of the thyroid cartilage, the entire hypopharyngeal mucosa and epiglottis are preserved. The superior laryngeal vessels and nerve are not invaded. All fifteen patients were relieved of aspiration without major complications. In good accordance with cutting of the cricopharyngeal muscles and removal of the cricoid cartilage, postoperative videofluoroscopy demonstrated smooth passages of barium. Ten of 12 patients who had hoped to resume oral food intake became able to do so after CPL and two others also achieved partial oral deglutition. CPL is a useful procedure for treatment of intractable aspiration and offers considerable advantages over other laryngotracheal diversion procedures from the view point of oral food intake.
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan, putchsan@mail.goo.ne.jp.
authors.forename: Ai
authors.initials: A
authors.lastname: Kawamoto
authors.forename: Yukio
authors.initials: Y
authors.lastname: Katori
authors.forename: Yohei
authors.initials: Y
authors.lastname: Honkura
authors.forename: Risako
authors.initials: R
authors.lastname: Kakuta
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Higashi
authors.forename: Masaki
authors.initials: M
authors.lastname: Ogura
authors.forename: Makiko
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Kazuya
authors.initials: K
authors.lastname: Arakawa
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kashima
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Asada
authors.forename: Kazuto
authors.initials: K
authors.lastname: Matsuura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003413:Cricoid Cartilage / Q000601:surgery; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D005931:Glottis / Q000601:surgery; D006801:Humans; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis; D053120:Respiratory Aspiration / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D013957:Thyroid Cartilage / Q000601:surgery; D014741:Video Recording
chemical_list: D001466:Barium Sulfate