Central-part laryngectomy is a useful and less invasive surgical procedure for resolution of intractable aspiration

Eur Arch Otorhinolaryngol. 2014 May;271(5):1149-55. doi: 10.1007/s00405-013-2725-4. Epub 2013 Oct 18.

Abstract

A novel narrow-field laryngectomy procedure known as central-part laryngectomy (CPL) for less invasive laryngeal diversion in patients with intractable aspiration is introduced. We conducted retrospective case reviews of 15 patients who underwent CPL. In this procedure, an area of the glottis including the mid-part of the thyroid cartilage and cricoid cartilage is removed to separate the digestive tract from the air way. The lateral part of the thyroid cartilage, the entire hypopharyngeal mucosa and epiglottis are preserved. The superior laryngeal vessels and nerve are not invaded. All fifteen patients were relieved of aspiration without major complications. In good accordance with cutting of the cricopharyngeal muscles and removal of the cricoid cartilage, postoperative videofluoroscopy demonstrated smooth passages of barium. Ten of 12 patients who had hoped to resume oral food intake became able to do so after CPL and two others also achieved partial oral deglutition. CPL is a useful procedure for treatment of intractable aspiration and offers considerable advantages over other laryngotracheal diversion procedures from the view point of oral food intake.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Barium Sulfate
  • Cricoid Cartilage / surgery
  • Deglutition Disorders / etiology
  • Deglutition Disorders / surgery*
  • Female
  • Fluoroscopy
  • Glottis / surgery
  • Humans
  • Laryngectomy / methods*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Postoperative Complications / diagnosis
  • Respiratory Aspiration / diagnosis
  • Respiratory Aspiration / surgery*
  • Retrospective Studies
  • Thyroid Cartilage / surgery
  • Video Recording

Substances

  • Barium Sulfate