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Epiglottic plication for intractable aspiration

J P Harcourt1, G B Brookes

  • 1Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, London, UK.

Clinical Otolaryngology and Allied Sciences
|August 1, 1996
PubMed
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Zhonghua er bi yan hou ke za zhi·2003

A new surgical technique plicates the epiglottis to prevent airway aspiration, allowing speech and potentially decannulation. This procedure is for severe aspiration cases unresponsive to conservative treatments.

Area of Science:

  • Otolaryngology
  • Surgical Innovation

Background:

  • Intractable aspiration poses a significant risk to the airway.
  • Conservative treatments are often insufficient for severe aspiration cases.

Purpose of the Study:

  • To describe a novel surgical procedure for intractable aspiration.
  • To evaluate the efficacy of epiglottic plication combined with cricopharyngeal myotomy.

Main Methods:

  • Surgical plication of the epiglottis into a vertical tube.
  • Extensive cricopharyngeal myotomy performed in conjunction with epiglottic plication.
  • Procedure evaluated in nine patients with severe aspiration.

Main Results:

  • Six out of nine patients achieved satisfactory outcomes.

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  • Two patients were successfully decannulated (tracheostomy reversal).
  • Two late post-operative deaths occurred due to infective causes.

    • Conclusions:

    • Epiglottic plication with cricopharyngeal myotomy is a viable option for select patients with severe aspiration.
    • The procedure can preserve or restore laryngeal speech and potentially allow tracheostomy reversal.
    • Patient selection is crucial due to the risks associated with the surgery and patient debility.