[Surgical management of refractory dysphagia and aspiration].
OBJECTIVE
To explore the methods and results of surgical management for refractory dysphagia and aspiration.


METHODS
The clinical data of 24 refractory dysphagia and aspiration patients who accepted surgical management were retrospectively analysed.


RESULTS
Twenty-four refractory dysphagia and aspiration patients accepted 26 operations between 2001 and 2014. Of the 26 operations, 17 were cricopharyngeal myectomy (CPM), 6 were scarectomy, 3 were laryngeal-tracheal separation. No severe complications occurred. Assessments of dysphagia were completed in 18 operations before and after operation. Aspiration scores of videofluoroscopic swallowing study (VFSS) were 4.50 [4.00;7.00] vs 2.00 [1.00; 3.25], P = 0.000; swallow dysfunction scroes of VFSS were 5.00 [4.00; 12.00] vs 1.00 [1.50; 10.00], P = 0.001; aspiration scores of fibroptic endoscopic evaluation of swallowing (FEES) were 4.00 [5.00; 7.00] vs 2.00 [1.75; 3.00], P = 0.000. But the surgical results for post radiotherapy dysphagia were not successful (n = 5): aspiration scores of VFSS were 7.00 [6.50; 8.00] vs 6.00 [2.00; 7.50], P = 0.109;swallow dysfunction scroes of VFSS were 12.00 [10.50; 12.00] vs 12.00 [7.50; 12.00], P = 0.180;aspiration scores of FEES were 7.00 [6.50; 8.00] vs 6.00 [2.00; 7.50], P = 0.109.


CONCLUSIONS
Surgical management was effective for refractory dysphagia and aspiration, but the surgical indication selection should be strict.
Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing 100730, China.
Jian
J
Wang
Email: liwuyi@sina.com.
Wuyi
W
Li
Jianhan
J
Liu
Chunxiao
C
Xu
Dahai
D
Yang
Hong
H
Huo
Xu
X
Tian
Zhuhua
Z
Zhang
Yu
Y
Chen
D003680:Deglutition Disorders / Q000601:surgery*; D004724:Endoscopy; D005471:Fluoroscopy; D006801:Humans; D007830:Larynx; D007831:Larynx, Artificial; D012189:Retrospective Studies; D014132:Trachea