Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-23T06:37:41.766Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical outcomes of tracheoesophageal diversion for intractable aspiration

Published online by Cambridge University Press:  23 February 2015

K Adachi ,
T Umezaki ,
H Kiyohara ,
H Miyaji  and
S Komune
K Adachi*
Affiliation:
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
T Umezaki
Affiliation:
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
H Kiyohara
Affiliation:
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
H Miyaji
Affiliation:
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
S Komune
Affiliation:
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
*
Address for correspondence: Kazuo Adachi, Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan Fax: +81 92 6425685 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

The purpose of the present study was to examine the clinical outcomes of using tracheoesophageal diversion for preventing intractable aspiration.

Method:

We retrospectively reviewed 25 patients who underwent tracheoesophageal diversion from 2003 to 2009 at our hospital (median age, 25 years; range, 0–78 years). End-to-side anastomosis was used in 16 cases and side-to-side anastomosis was used in 9.

Results:

The average operative time was 141 minutes for end-to-side anastomosis and 191 minutes for side-to-side anastomosis. Peri-operative complications were observed in only two (8 per cent) cases: one with infection and one with haematoma. No fistulas were observed. Aspiration was prevented in all cases, but the nutritional route depended on the swallowing function of the patient. Oral feeding was the main nutritional route after surgery in only four patients (16 per cent).

Conclusion:

This procedure is well suited to patients who lack speech communication and are at high risk of aspiration.

Keywords

Respiratory AspirationSurgical AnastomosisFistulaTracheotomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue S2 , March 2015 , pp. S69 - S73
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Lindeman, RC. Diverting the paralyzed larynx: a reversible procedure for intractable aspiration. Laryngoscope 1975;85:157–80Google Scholar
2Krespi, YP, Quatela, VC, Sisson, GA, Som, ML. Modified tracheoesophageal diversion for chronic aspiration. Laryngoscope 1984;94:1298–301CrossRefGoogle ScholarPubMed
3Yarington, CT, Sutton, D. Clinical experience with the tracheoesophageal anastomosis for intractable aspiration. Ann Otol Rhinol Laryngol 1976;85:609–12Google ScholarPubMed
4Baron, BC, Dedo, HH. Separation of the larynx and trachea for intractable aspiration. Laryngoscope 1980;90:1927–32CrossRefGoogle ScholarPubMed
5Montgomery, WW. Surgery to prevent aspiration. Arch Otolaryngol 1975;101:679–82Google Scholar
6Sasaki, CT, Milmoe, G, Yanagisawa, E, Berry, K, Kirchner, JA. Surgical closure of the larynx for intractable aspiration. Arch Otolaryngol 1980;106:422–3CrossRefGoogle ScholarPubMed
7Habal, MB, Murray, JE. Surgical treatment of life-endangering chronic aspiration pneumonia. Plast Reconst Surg 1972;49:305–11Google Scholar
8Biller, HF, Lawson, W, Beak, SM. Total glossectomy. Arch Otolaryngol 1983;109:69–73Google Scholar
9Zocratto, OB, Savassi-Rocha, PR, Paixão, RM, Salles, JM. Laryngotracheal separation surgery: outcome in 60 patients. Otolaryngol Head Neck Surg 2006;135:571–5Google Scholar
10Eibling, DE, Snyderman, CH, Eibling, C. Laryngotracheal separation for intractable aspiration: a retrospective review of 34 patients. Laryngoscope 1995;105:83–5CrossRefGoogle ScholarPubMed
11Manrique, D, Settanni, FA, Camponês do Brasil Ode, O. Surgery for aspiration: analysis of laryngotracheal separation in 23 children. Dysphagia 2006;21:254–8Google Scholar
12Eisele, DW, Yarington, CT Jr, Lindeman, RC, Larrabee, WF Jr. The tracheoesophageal diversion and laryngotracheal separation procedures for treatment of intractable aspiration. Am J Surg 1989;157:230–6Google Scholar
13Pletcher, SD, Mandpe, AH, Block, MI, Cheung, SW. Reversal of laryngotracheal separation: a detailed case report with long-term followup. Dysphagia 2005;20:19–22CrossRefGoogle ScholarPubMed
14Tomita, T, Tanaka, K, Shinden, S, Ogawa, K. Tracheoesophageal diversion versus total laryngectomy for intractable aspiration. J Laryngol Otol 2004;118:15–18Google Scholar