[Laryngeal closure--a simple method and a reversible method for phonation preservation]

Patients with dysphagia due to a disorder in swallowing phase II are candidates for laryngeal closure operation. The operation prevents bolus drainage into the larynx and therefore permits oral feeding. Operative methods in general should be simple and reliable, and furthermore, with regards to this laryngeal closure procedure, they should preferably be reversible to maintain phonatory function, in the event that patients improve swallowing function later on. A laryngeal closure operation which satisfies both conditions has not been previously reported. We present two laryngeal closure operations. One is relatively simple and reliable but irreversible in terms of phonatory function. The other procedure requires more effort but is reversible and therefore allows for preservation of phonatory function. We performed one of these operations on two cases each and obtained good results. 1. Laryngeal closure at the vocal cords. (simple method) The frontal neck skin is incised vertically. The thyroid cartilage perichondrium is incised in the midline and retracted widely on both sides. Then the anterior thyroid lamina is removed at the crico-arytenoid joint. A control hole is opened into the laryngeal lumen by an incision made from the cricoarytenoid membrane to the anterior commissure. The larynx is cut horizontally from the anterior to posterior commissure between the upper and lower lips of the vocal cords. Finally the vocal cords are sutured at the top and bottom of the cut stump. 2. Closure at the false vocal cords. (reversible method for phonation preservation) After the vertical incision has been made, the laryngeal lumen is opened by laryngofissure.(ABSTRACT TRUNCATED AT 250 WORDS)