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A guided approach to surgery for aspiration: two case reports

Published online by Cambridge University Press:  29 June 2007

Martyn Mendelsohn
Martyn Mendelsohn*
Affiliation:
Department of Otolaryngology. Mount Sinai Hospital and University of Toronto, Toronto, Canada
*
Martyn Mendelsohn, F.R.A.C.S., 68 Ourimbah Road, Mosman, NSW, 2088, Australia
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Abstract

Aspiration frequently occurs in patients with a competent glottis. Analysis using a modified barium swallow (MBS) can reveal an extraglottic mechanism of aspiration in these patients. The MBS examination guided the design of two surgical procedures in patients with severe aspiration. The surgery corrected the underlying extraglottic cause of aspiration while preserving glottic function. In one case the epiglottoplasty controlled aspiration due to spillage over the epiglottis into the airway. In the other case translaryngeal resection of the cricoid lamina combined with cricopharyngeal myotomy controlled aspiration of residue in the hypopharynx. After surgery, both patients had their gastrostomy and cuffed tracheostomy tubes removed and were discharged home on a normal oral diet. Detailed analysis of deglutition by a modified barium swallow canprovide a scientific basis to guide the surgical management of patients with severe dysphagia.

Keywords

Deglutition disordersAspirationBarium swallowmodified
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 2 , February 1993 , pp. 121 - 126
Copyright
Copyright © JLO (1984) Limited 1993

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Footnotes

Presented in part at Swallowing and Laryngology: State of the Art, Atlanta, Georgia, May 2, 1992.

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