title: Effectiveness of laryngotracheal separation in neurologically impaired pediatric patients.
abstract: CONCLUSIONS
  Laryngotracheal separation (LTS) can prevent aspiration pneumonia, improve the respiratory condition, and offer the possibility of home care for neurologically impaired children.
  
  
  OBJECTIVE
  This study aimed to evaluate the effectiveness of LTS in neurologically impaired pediatric patients from the viewpoint of postoperative success of pneumonia prevention, improvement in the respiratory condition, and postoperative success rate of home-based care.
  
  
  METHODS
  The medical records of 21 children who underwent LTS at an academic medical center from September 2004 to March 2013 were retrospectively investigated. Pre- and postoperative data, including the frequency of pneumonia treatment, the frequency of sputum suctioning, the respiratory condition, the nutrition method, and the outcome after LTS were assessed. We also used the scoring system for patients with severe motor and intellectual disabilities, medical care dependent group (SMID-MCDG) in Japan for evaluating the usefulness of LTS.
  
  
  RESULTS
  The frequency of pneumonia treatment and that of suctioning decreased considerably after LTS. Furthermore, the respiratory condition improved at a rate of 63.19%. The SMID-MCDG score significantly reduced after LTS. No significant complications were observed and two-thirds of the patients were successfully discharged for home care after the procedure.
authors.affiliation: Department of Otolaryngology, Yamaguchi University Graduate School of Medicine , Ube, Yamaguchi.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Hara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hori
authors.forename: Kazuma
authors.initials: K
authors.lastname: Sugahara
authors.forename: Takuo
authors.initials: T
authors.lastname: Ikeda
authors.forename: Madoka
authors.initials: M
authors.lastname: Kajimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamashita
mesh_terms: D058109:Airway Management / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006699:Home Care Services; D006801:Humans; D007830:Larynx / Q000601:surgery*; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control*; D012120:Respiration Disorders / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery*; D016896:Treatment Outcome
keywords: Aspiration pneumonia; outcome; respiratory condition