Intractable aspiration in a young child and its surgical management

Intractable aspiration is a life-threatening condition. The problems encountered in a young child with severe intractable aspiration due to bilateral bulbar palsy following the surgical removal of a cerebellar astrocytoma are described. The various options of surgical treatment are discussed and Sasaki's technique of triple layer closure of the larynx using a superiorly based sternohyoid muscle flap is outlined in detail.