Transoral closure of the supraglottic larynx for intractable aspiration

Head & Neck ◽  
2020 ◽  
Author(s):  
Ihab Atallah ◽  
Paul F. Castellanos
Keyword(s):  
Intractable Aspiration ◽  
Supraglottic Larynx

Functional Restoration after Subtotal Glossectomy and Laryngectomy

1988 ◽  
Vol 98 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Moises Mitrani ◽  
Yosef P. Krespi
Keyword(s):  
Functional Results ◽  
Pulmonary Complications ◽  
Functional Restoration ◽  
Tongue Base ◽  
Extensive Resection ◽  
Mucosal Defect ◽  
Radiotherapy Alone ◽  
Intractable Aspiration ◽  
Posterior Tongue ◽  
Supraglottic Larynx

Extensive resection of carcinoma that involves the tongue base and supraglottic larynx is accompanied by significant potential morbidity and mortality. This is often indicated by poor rates of cure and the limited palliation afforded by radiotherapy alone. Removal of a significant portion of the posterior tongue frequently results in intractable aspiration. Techniques in reconstruction of the oropharyngeal defect and tongue base have included primary closure, random flaps, and myocutaneous flaps. Each of these techniques has been successful, to some degree, in resurfacing pharyngeal defects. However, the functional results in regard to deglutition are less than satisfactory as a result of aspiration. Frequently, simultaneous or delayed total laryngectomy is performed to deal with the pulmonary complications. Various types of laryngoplasty do not uniformly correct the problems of aspiration and deglutition associated with subtotal glossectomy. Our experience includes eight patients who had advanced squamous cell carcinoma of the tongue base, vallecula, and the supraglottic larynx. All patients underwent partial or subtotal glossectomy and laryngectomy. The mucosal defect was reconstructed with pectoralis myocutaneous flap. In order to reestablish voice, a primary tracheopharyngeal shunt was created with the use of a portion of cricoid and upper trachea. The majority of these patients have had successful rehabilitation of deglutition, mastication, and speech.

Method and Clinical Results of a New Transthyrotomy Closure of the Supraglottic Larynx for the Treatment of Intractable Aspiration

1997 ◽  
Vol 106 (6) ◽  
pp. 451-460 ◽  
Author(s):  
Paul F. Castellanos
Keyword(s):  
Decision Making ◽  
Surgical Procedure ◽  
Vocal Folds ◽  
Clinical Results ◽  
Decision Making Process ◽  
Surgical Decision ◽  
Intractable Aspiration ◽  
False Vocal ◽  
Surgical Decision Making ◽  
Supraglottic Larynx

A new procedure has been developed to surgically separate the pharynx from the trachea that employs the best features of the Montgomery technique, but restricts the closure to only the epiglottis and the aryepiglottic folds. The petiole of the epiglottis is plicated to the false vocal folds and the interarytenoid mucosa. It is performed entirely through a midline thyrotomy approach and avoids injury to any of the structures within the rima glottidis. It has been successfully performed on seven very ill patients to date. The surgical decision-making process involved, a complete description of the surgical procedure, and a summary of the patients' preoperative condition, workup, and outcomes are presented and discussed.

Tracheoesophageal Diversion and Puncture for Preserving Phonation in Intractable Aspiration: A Case Series

2020 ◽  
Author(s):  
Kazuo Adachi ◽  
Toshiro Umezaki ◽  
Takashi Inoguchi ◽  
Naoko Matsubara ◽  
Norimoto Kise ◽  
...  
Keyword(s):  
Case Series ◽  
Intractable Aspiration

Kaposi's Sarcoma of the Larynx

1997 ◽  
Vol 106 (7) ◽  
pp. 563-567 ◽  
Author(s):  
Neil F. Schiff ◽  
Peak Woo ◽  
Donald J. Annino ◽  
Stanley M. Shapshay
Keyword(s):  
Carbon Dioxide Laser ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Vascular Disorder ◽  
Voice Change ◽  
Aids Epidemic ◽  
Number Of Patients ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Supraglottic Larynx

Kaposi's sarcoma (KS) is a neoplastic vascular disorder, classically arising in the skin of the lower extremities. As a consequence of the acquired immunodeficiency syndrome (AIDS) epidemic, an increasing number of patients have been found to have KS. In AIDS patients, KS appears to exhibit a more diffuse nature and frequently affects the head and neck. Mucosal lesions are most often seen, commonly involving the oral cavity. Only rare cases of laryngeal involvement have been recorded in the literature. We report 2 cases of KS of the supraglottic larynx. Our first patient, an elderly man of Mediterranean descent, complained of voice change and throat discomfort. Endoscopy with biopsy for diagnosis allowed conservative treatment with chemotherapy. Our second patient was a younger man with AIDS who presented with symptoms of airway obstruction. Management with carbon dioxide laser epiglottectomy was successful in relieving that patient's symptoms. Although rare, KS may present in both healthy and immunocompromised patients, and must be considered in the differential diagnosis of all violaceous lesions of the larynx.

Morale and Depression in Patients Treated Surgically for Intractable Aspiration-To the Editor

CHEST Journal ◽  
2000 ◽  
Vol 118 (2) ◽  
pp. 565
Author(s):  
Yoshihisa Takano ◽  
Osamu Sakamoto ◽  
Moritaka Suga ◽  
Masayuki Ando
Keyword(s):  
Intractable Aspiration

RELATIONSHIP BETWEEN GLASGOW COMA SCALE AND AIRWAYS PROTECTIVE REFLEXES IN CEREBRO VASCULAR ATTACK PATIENTS

2021 ◽  
pp. 81-83
Author(s):  
Sonakshi Saha ◽  
Indraneel Dasgupta ◽  
Amit Bhowmik
Keyword(s):  
Prospective Observational Study ◽  
Indian Population ◽  
Clinical History ◽  
Mechanical Ventilator ◽  
Senior Physician ◽  
Cough Test ◽  
Group 15 ◽  
The Central Nervous System ◽  
Supraglottic Larynx ◽  
Selection Of

Introduction: The laryngeal cough reex (LCR) protects the supraglottic larynx from signicant aspiration of food or uids during inspiration or pharyngeal spillage during swallowing 1. The reex cough test (RCT), using nebulized tartaric acid solution, provides an effective stimulus to the receptors in the supraglottic mucosa, and, like a reex hammer or percussor, triggers a cascade of neurological activity in both craniospinal nerves and the central nervous system. The vagus nerve mediates the afferent component of the LCR. Aims And Objective:To nd the relation between glasgowcoma scale and airway protective reexes in Indian population. Materials And Methods: This study was a prospective observational study. Clinical history and examination is mandatory for selection of the eligible patients. All the procedure was done, only once a traumatically, in patients. Suction apparatus was made available all the time beside the patients in case they vomit. Procedure was done under supervision of senior physician. Result And Analysis: We found that in ≤5 GCS Group, 15(100.0%) patients had Intubation. In 6-8 GCS Group, 7(10.6%) patients had Intubation. In ≥9 GCS Group, 8(20.5%) patients had Intubation. Association of Intubation vs GCS Group was statistically signicant (p<0.0001). In ≤5 GCS Group, 15(100.0%) patients had Immediate Intubation. Summary And Conclusion: In our study, 11(9.2%) patients were Attenuated/ Diminished (Absent Cough and Gag reex) air way protective reexes checked later, 19(15.8%) patients were Not Applicable (As Pt Mechanical Ventilator) air way protective reexes checked later and 90(75.0%) patients were Patent (Present Cough and Gag reex) air way protective reexes checked later. Mechanical Ventilator was more in low GCS (≤5) which was statistically signicant.

Clinical Outcome of Laryngotracheal Separation for Intractable Aspiration Pneumonia

ORL ◽  
2001 ◽  
Vol 63 (5) ◽  
pp. 321-324 ◽  
Author(s):  
Takayo Yamana ◽  
Hiroya Kitano ◽  
Masakazu Hanamitsu ◽  
Kazutomo Kitajima
Keyword(s):  
Clinical Outcome ◽  
Aspiration Pneumonia ◽  
Laryngotracheal Separation ◽  
Intractable Aspiration

Salvage surgery following radiation failure in squamous cell carcinoma of the supraglottic larynx

1995 ◽  
Vol 32 (3) ◽  
pp. 605-609 ◽  
Author(s):  
James T. Parsons ◽  
William M. Mendenhall ◽  
Scott P. Stringer ◽  
Nicholas J. Cassisi ◽  
Rodney R. Million
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Salvage Surgery ◽  
Supraglottic Larynx
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