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Transoral closure of the supraglottic larynx for intractable aspiration
Author(s) -
Atallah Ihab,
Castellanos Paul F.
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26599
Subject(s) - medicine , surgery , aspiration pneumonia , larynx , laryngoplasty , airway , complication , pneumonia
The aim of this paper is to describe a novel, safe, and effective surgical technique to eliminate aspiration, that is performed entirely by reconstructive transoral laser microsurgery (R‐TLM). Eleven tracheostomy‐dependent patients with recurrent pneumonia secondary to intractable aspiration treated with transoral laryngeal closure were included in our study. In all cases, the supraglottic mucosa is incised in a circumferential manner. The distal tissues are sutured side‐to‐side longitudinally, and the superficial tissues are sutured back‐to‐front transversally. All patients successfully underwent transoral laryngeal closure without significant perioperative complication. Four patients resumed oral feeding for effective nutrition and two patients for pleasure. One patient developed a small fistula with a leak that warranted secondary closure by a follow‐up R‐TLM procedure and subsequently held to protect his airway. Complete supraglottic laryngeal closure can be performed safely and effectively using R‐TLM techniques. They provide a natural‐orifice alternative to open surgery in patients with intractable aspiration.