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A guided approach to surgery for aspiration: two case reports
1Department of Otolaryngology, Mount Sinai Hospital, Toronto, Canada.
The Journal of Laryngology and Otology
|February 1, 1993
Summary
Modified barium swallow analysis identified extraglottic aspiration mechanisms in patients with competent glottis. Surgical interventions corrected these causes, restoring safe oral feeding and removing feeding tubes.
Area of Science:
- Otolaryngology
- Gastroenterology
- Speech-Language Pathology
Background:
- Aspiration is common in patients with a functional glottis.
- Extraglottic mechanisms are often responsible for aspiration in these cases.
Observation:
- Modified barium swallow (MBS) identified specific extraglottic causes of aspiration.
- Two surgical procedures were designed based on MBS findings to address severe aspiration.
Findings:
- Epiglottoplasty successfully managed aspiration from epiglottic spillage.
- Translingual resection of the cricoid lamina and cricopharyngeal myotomy addressed hypopharyngeal residue aspiration.
- Both patients were discharged with normal oral diets, with feeding and tracheostomy tubes removed.
Implications:
- MBS provides a scientific basis for surgical management of severe dysphagia.
- Surgical correction of extraglottic aspiration preserves glottic function.
- Effective surgical interventions can restore safe swallowing and improve patient quality of life.