Satisfaction of Patients Treated Surgically for Intractable Aspiration

Takano, Yoshihisa; Suga, Moritaka; Sakamoto, Osamu; Sato, Keizo; Samejima, Yasuhiro; Ando, Masashi

doi:10.1378/chest.116.5.1251

Cited by 41 publications

(35 citation statements)

References 16 publications

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“…The methods must be simple and definitive because patients with chronic aspiration usually have impaired respiratory function. Techniques for complete separation of the alimentary and respiratory passages include laryngeal closure, laryngectomy, laryngotracheal separation (LTS) and tracheoesophageal diversion (TED) [1][2][3][4]. The most significant morbidity of these procedures is loss of phonation.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcome of Laryngotracheal Separation for Intractable Aspiration Pneumonia

Yamana

Kitano

Hanamitsu

et al. 2001

ORL

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Objectives: To confirm that laryngotracheal separation (LTS) is a satisfactory treatment for patients with intractable aspiration pneumonia, even though it does not require tracheoesophageal anastomosis. Study Design: Retrospective. Methods: Nine patients with intractable aspiration pneumonia underwent LTS at our institution from 1996 to 1999. Two patients underwent postoperative barium swallow radiography. Results: Neither halitosis nor stimulation of the cough reflex occurred due to pooled secretions in the blind pouch of the proximal tracheal segment. Barium swallow radiography confirmed that the secretions drained within 40 min by swallowing or a change in patient position. Conclusion: LTS is a satisfactory solution to the problem of chronic aspiration. Neither pooled secretions in the proximal tracheal segment nor fistula formation were significant postoperative problems.

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Section: Introductionmentioning

confidence: 99%

Clinical Outcome of Laryngotracheal Separation for Intractable Aspiration Pneumonia

Yamana

Kitano

Hanamitsu

et al. 2001

ORL

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“…The procedure is preferred by most authors over other types of laryngeal closure and has become the standard method for the treatment and prevention of severe and clinically intractable aspiration at many institutions [10,16,20]. The main advantages of LTS are technical simplicity, reliability, preservation of swallowing capacity, short duration of surgery, and no need for a tracheoesophageal anastomosis as is the case in tracheoesophageal diversion [13].…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcomes of Reversal of Laryngotracheal Separation

2010

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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.

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“…However, disordered breathing comprises a variety of breathing abnormalities such as central sleep apnea, Cheyne±Stokes breathing, gasping, and choking. Patients with mental retardation sometimes exhibit swallowing diculty and apnea [27,28]. Thus, underlying neuromuscular disorders should be considered in OSAS.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Swallowing Function and Gas Exchange During Day and Night in Patients with Obstructive Sleep Apnea Syndrome

2001

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Patients with obstructive sleep apnea syndrome (OSAS) are likely to exhibit an impaired swallowing reflex. However, mechanisms of disturbed swallowing reflex have not been determined. Because the upper-airway function is inhibited by hypoxia and hypercapnia, we examined the relationship between the swallowing function and gas exchange during day and night in patients with OSAS. Twenty-four patients with OSAS and 24 age-matched controls were studied. OSAS was diagnosed from overnight polysomnography. The swallowing reflex was judged by the latent time (LT) for swallowing following bolus injection of distilled water at the suprapharynx, the inspiratory suppression time (IST) from swallowing termination to the next onset of inspiration, and the threshold for evoking the swallowing response in terms of a volume of water (TV). Whereas the LT values are positively correlated with PaCO2 but not with PaO2 during the day, the values of IST and TV were not associated with daytime PaCO2 or PaO2. Nocturnal nadir SaO2 was correlated with LT, IST, and TV. These results indicate that oxyhemoglobin desaturation and hypercapnia may be associated with one of the mechanisms of the impaired swallowing function in patients with OSAS.

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Satisfaction of Patients Treated Surgically for Intractable Aspiration

Cited by 41 publications

References 16 publications

Clinical Outcome of Laryngotracheal Separation for Intractable Aspiration Pneumonia

Clinical Outcome of Laryngotracheal Separation for Intractable Aspiration Pneumonia

Long-term Outcomes of Reversal of Laryngotracheal Separation

Relationship Between Swallowing Function and Gas Exchange During Day and Night in Patients with Obstructive Sleep Apnea Syndrome

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