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Erschienen in: Dysphagia 2/2011

01.06.2011 | Original Article

Long-term Outcomes of Reversal of Laryngotracheal Separation

verfasst von: Orlando B. Zocratto, Paulo R. Savassi-Rocha, Rafael M. Paixão

Erschienen in: Dysphagia | Ausgabe 2/2011

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Abstract

The aim of this study was to evaluate the long-term outcomes of the reversal of laryngotracheal separation (LTS) in patients who underwent extensive resection of tumors located in the upper aerodigestive tract. We performed a retrospective analysis of the medical records of eight patients who had LTS reversal. The operation was successful in six patients who were followed up for a period of 17-99 months (mean = 46.3 ± 26.2). The mean interval between LTS and surgical reversal was 16.6 ± 9.1 months. Four patients had postoperative complications: mild to moderate transient aspiration in two, tracheal stenosis in one, and severe aspiration followed by tracheal stenosis in one. In the last two cases, surgical reversal was not successful. The patients whose surgery was effective maintained oral feeding and comprehensible speech until the end of the follow-up period. We conclude that reversal of LTS is technically simple and, when successful, permits the return to oral feeding and comprehensible speech for an indefinite period of time. However, the frequency of complications and inefficacy of LTS reversal should not be overlooked.
Literatur
1.
Zurück zum Zitat Logemann JA. Aspiration in head and neck surgical patients. Ann Otol Rhinol Laryngol. 1985;94:373–6.PubMed Logemann JA. Aspiration in head and neck surgical patients. Ann Otol Rhinol Laryngol. 1985;94:373–6.PubMed
2.
Zurück zum Zitat Snyderman CH, Johnson JT. Laryngotracheal separation for intractable aspiration. Ann Otol Rhinol Laryngol. 1988;97:466–70.PubMed Snyderman CH, Johnson JT. Laryngotracheal separation for intractable aspiration. Ann Otol Rhinol Laryngol. 1988;97:466–70.PubMed
3.
Zurück zum Zitat Halama AR. Surgical treatment of oropharyngeal swallowing disorders. Acta Otorhinolaryngol Belg. 1994;48:217–27.PubMed Halama AR. Surgical treatment of oropharyngeal swallowing disorders. Acta Otorhinolaryngol Belg. 1994;48:217–27.PubMed
4.
Zurück zum Zitat Eisele DW, Yarington CT, Lindeman RC. Indications for the tracheoesophageal diversion procedure and the laryngotracheal separation procedure. Ann Otol Rhinol Laryngol. 1988;97:471–5.PubMed Eisele DW, Yarington CT, Lindeman RC. Indications for the tracheoesophageal diversion procedure and the laryngotracheal separation procedure. Ann Otol Rhinol Laryngol. 1988;97:471–5.PubMed
5.
Zurück zum Zitat Lindeman RC, Yarington CT Jr, Sutton D. Clinical experience with the tracheoesophageal anastomosis for intractable aspiration. Ann Otol Rhinol Laryngol. 1976;85:609–12. Lindeman RC, Yarington CT Jr, Sutton D. Clinical experience with the tracheoesophageal anastomosis for intractable aspiration. Ann Otol Rhinol Laryngol. 1976;85:609–12.
6.
Zurück zum Zitat Habal MB, Murray JE. Surgical treatment of life-endangering chronic aspiration pneumonia. Use of an epiglottic flap to the arytenoids. Plast Reconstr Surg. 1972;49:305–11.PubMedCrossRef Habal MB, Murray JE. Surgical treatment of life-endangering chronic aspiration pneumonia. Use of an epiglottic flap to the arytenoids. Plast Reconstr Surg. 1972;49:305–11.PubMedCrossRef
7.
Zurück zum Zitat Montgomery W. Surgery to prevent aspiration. Arch Otolaryngol. 1975;101:679–82.PubMed Montgomery W. Surgery to prevent aspiration. Arch Otolaryngol. 1975;101:679–82.PubMed
8.
Zurück zum Zitat Sasaki CT, Milmoe G, Yanagisawa E, Berry K, Kirchner JA. Surgical closure of the larynx for intractable aspiration. Arch Otolaryngol. 1980;106:422–3.PubMed Sasaki CT, Milmoe G, Yanagisawa E, Berry K, Kirchner JA. Surgical closure of the larynx for intractable aspiration. Arch Otolaryngol. 1980;106:422–3.PubMed
9.
Zurück zum Zitat Eisele DW, Yarington CT, Lindeman RC, Larrabee WF Jr. The tracheoesophageal diversion and laryngotracheal separation procedures for intractable aspiration. Am J Surg. 1989;157:230–6.PubMedCrossRef Eisele DW, Yarington CT, Lindeman RC, Larrabee WF Jr. The tracheoesophageal diversion and laryngotracheal separation procedures for intractable aspiration. Am J Surg. 1989;157:230–6.PubMedCrossRef
10.
Zurück zum Zitat Eibling DE, Snyderman CH, Eibling C. Laryngotracheal separation for intractable aspiration: a retrospective review of 34 patients. Laryngoscope. 1995;105:83–5.PubMedCrossRef Eibling DE, Snyderman CH, Eibling C. Laryngotracheal separation for intractable aspiration: a retrospective review of 34 patients. Laryngoscope. 1995;105:83–5.PubMedCrossRef
11.
Zurück zum Zitat Paixão RM. What are indications and surgical techniques used to treat clinically intractable aspiration? In: Castro LP, Savassi-Rocha PR, Cunha-Melo JR, Costa MMB, editors. Topics in gastroenterology 10: swallowing and dysphagy. Rio de Janeiro: MEDSI; 2000. p. 215–23. Paixão RM. What are indications and surgical techniques used to treat clinically intractable aspiration? In: Castro LP, Savassi-Rocha PR, Cunha-Melo JR, Costa MMB, editors. Topics in gastroenterology 10: swallowing and dysphagy. Rio de Janeiro: MEDSI; 2000. p. 215–23.
12.
Zurück zum Zitat Zocratto OB, Savassi-Rocha PR, Paixão RM, Salles JM. Laryngotracheal separation surgery: outcome in 60 patients. Otolaryngol Head Neck Surg. 2006;135:571–5.PubMedCrossRef Zocratto OB, Savassi-Rocha PR, Paixão RM, Salles JM. Laryngotracheal separation surgery: outcome in 60 patients. Otolaryngol Head Neck Surg. 2006;135:571–5.PubMedCrossRef
13.
Zurück zum Zitat Lindeman RC. Diverting the paralysed larynx: a reversible procedure for intractable aspiration. Laryngoscope. 1975;85:157–80.PubMedCrossRef Lindeman RC. Diverting the paralysed larynx: a reversible procedure for intractable aspiration. Laryngoscope. 1975;85:157–80.PubMedCrossRef
14.
Zurück zum Zitat Zietek E, Jaworowska E, Matyja G, Kawczyński M, Wasilewska M. Laryngotracheal separation procedure after oncological pharyngeal and laryngeal operations. Otolaryngol Pol. 2001;55:359–62 (in Polish).PubMed Zietek E, Jaworowska E, Matyja G, Kawczyński M, Wasilewska M. Laryngotracheal separation procedure after oncological pharyngeal and laryngeal operations. Otolaryngol Pol. 2001;55:359–62 (in Polish).PubMed
15.
Zurück zum Zitat Takamizawa S, Tsugawa C, Nishijima E, Muraji T, Satoh S. Laryngotracheal separation for intractable aspiration pneumonia in neurologically impaired children: experience with 11 cases. J Pediatr Surg. 2003;38:975–7.PubMedCrossRef Takamizawa S, Tsugawa C, Nishijima E, Muraji T, Satoh S. Laryngotracheal separation for intractable aspiration pneumonia in neurologically impaired children: experience with 11 cases. J Pediatr Surg. 2003;38:975–7.PubMedCrossRef
16.
Zurück zum Zitat Yamana T, Kitano H, Hanamitsu M, Kitajima K. Clinical outcome of laryngotracheal separation for intractable aspiration pneumonia. ORL J Otorhinolaryngol Relat Spec. 2001;63:321–4.PubMedCrossRef Yamana T, Kitano H, Hanamitsu M, Kitajima K. Clinical outcome of laryngotracheal separation for intractable aspiration pneumonia. ORL J Otorhinolaryngol Relat Spec. 2001;63:321–4.PubMedCrossRef
17.
Zurück zum Zitat Hricko P, Storck C, Schmid S, Stoeckli SJ. Partial cricotracheal resection for successful reversal of laryngotracheal separation in patients with chronic aspiration. Laryngoscope. 2006;116:786–90.PubMedCrossRef Hricko P, Storck C, Schmid S, Stoeckli SJ. Partial cricotracheal resection for successful reversal of laryngotracheal separation in patients with chronic aspiration. Laryngoscope. 2006;116:786–90.PubMedCrossRef
18.
Zurück zum Zitat Pletcher SD, Mandpe AH, Block MI, Cheung SW. Reversal of laryngotracheal separation: a detailed case report with long-term followup. Dysphagia. 2005;20:19–22.PubMedCrossRef Pletcher SD, Mandpe AH, Block MI, Cheung SW. Reversal of laryngotracheal separation: a detailed case report with long-term followup. Dysphagia. 2005;20:19–22.PubMedCrossRef
19.
Zurück zum Zitat American Joint Committee on Cancer. Manual for staging of cancer. Philadelphia: JB Lippincott; 1992. American Joint Committee on Cancer. Manual for staging of cancer. Philadelphia: JB Lippincott; 1992.
20.
Zurück zum Zitat Takano Y, Suga M, Sakamoto O, Sato K, Samejima Y, Ando M. Satisfaction of patients treated surgically for intractable aspiration. Chest. 1999;116:1251–6.PubMedCrossRef Takano Y, Suga M, Sakamoto O, Sato K, Samejima Y, Ando M. Satisfaction of patients treated surgically for intractable aspiration. Chest. 1999;116:1251–6.PubMedCrossRef
Metadaten
Titel
Long-term Outcomes of Reversal of Laryngotracheal Separation
verfasst von
Orlando B. Zocratto
Paulo R. Savassi-Rocha
Rafael M. Paixão
Publikationsdatum
01.06.2011
Verlag
Springer-Verlag
Erschienen in
Dysphagia / Ausgabe 2/2011
Print ISSN: 0179-051X
Elektronische ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-010-9284-2

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