Erschienen in:
01.05.2010 | Case Report
Closure of the larynx for intractable aspiration in neurologically impaired patients
verfasst von:
Yukihiro Tatekawa, Noriko Hosino, Tetsuo Hori, Michio Kaneko
Erschienen in:
Pediatric Surgery International
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Ausgabe 5/2010
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Abstract
We present three patients with intractable aspiration pneumonia in the setting of permanent neurologic impairment, who had received a tracheostomy and showed a juxtaposition of the innominate artery against the trachea. Neurologically impaired patients often show a juxtaposition or compression of the innominate artery against the trachea by chest deformity in the setting of severe scoliosis, which could result in a trachea-innominate artery fistula. For intractable aspiration, laryngotracheal separation is safely performed and effective in controlling aspiration, but is occasionally complicated by trachea-innominate artery fistula. As an alternative procedure, we performed a closure of the larynx in these three cases, using double flaps of the vocal folds and false vocal folds, as a treatment for intractable aspiration. After operation, the patients did well without complication or clinical evidence of recurrent aspiration.