Treatment of Intractable Aspiration Using a Laryngeal Stent or Obturator

Abstract

Twenty-five patients were treated with a laryngeal stent for potentially reversible chronic aspiration of life-threatening magnitude. The causes of the intractable aspiration were diverse and included chronic neurologic disease, extensive head and neck surgery, and severe gastroesophageal reflux. The advantages of this technique are noted in comparison to those of more invasive procedures. Disadvantages of the laryngeal stent and complications encountered are also covered. The long-term results show that all but one patient had a significant improvement in their chronic aspiration with the stent in place. However, only eight patients achieved adequate oral deglutition without aspiration following stent removal.

Intractable pulmonary aspiration in children: Which operation?

“…Treatment of intractable aspiration using a laryngeal stent or obturator was reported by Weisberger [12]. It is very effective temporary solution.…”

“…It is usually simple to insert endoscopically. However, leakage around the stent and laryngeal ulceration are adverse complications [12].…”

Laryngotracheal separation surgery for intractable aspiration: Our experience with 12 patients

“…It was shown to be somewhat effective and easy to place endoscopically, however was associated with leakage around the stent, laryngeal ulceration and patient discomfort [11]. It has not gained widespread acceptance as a technique for prevention of chronic aspiration.…”

A method for bronchoscopic evaluation of salivary aspiration in a disabled child

“…Medical options primarily involve the use of antimuscarinic agents to reduce saliva production. The surgical options available include bilateral submandibular gland excision and parotid duel ligation, tracheostomy with or without stent insertion, and laryngotracheal separation procedures [3, 4]. The most effective procedure to prevent salivary aspiration is laryngotracheal separation, which involves forming an end tracheostomy and connecting the oesophagus to the proximal trachea, thus producing total isolation of the airway [5, 6].…”