The usefulness of laryngotracheal separation in the treatment of severe motor and intellectual disabilities.

Pediatric Surgery International
Hideki ShimaTakeshi Aoba

Abstract

Intractable aspiration is a life-threatening medical problem in patients with severe motor and intellectual disabilities (SMID). Laryngotracheal separation (LTS) is a surgical procedure for the treatment of intractable aspiration which separates the upper respiratory tract from the digestive tract. We performed LTS for 14 patients with SMID to prevent intractable aspiration, performing two types of operation. The standard diversion procedure connected the upper trachea to the esophagus. The modified diversion includes closure of the proximal trachea and a high tracheostomy, avoiding a tracheoesophageal anastomosis. LTS was performed on 14 patients. Operations performed before the LTS included tracheostomy in four patients, fundoplication in six and gastrostomy in two. A standard diversion was performed in 11 patients and a modified diversion in 3. There were no operative complications. Eleven patients were safely transferred to home-care after their LTS. Twelve patients are still alive and two died some months after operation. One patient died from their primary disease and the other died a tracheo-innominate artery fistula (TIAF). We recently experienced a patient who was at high risk of developing a TIAF. LTS is an effective ...Continue Reading

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Citations

Feb 14, 2012·Journal of Pediatric Surgery·Hideaki SatoHiroaki Kitagawa
Feb 9, 2011·Acta Paediatrica·Ingeborg Y BartEsther de Vries
Aug 4, 2016·Orphanet Journal of Rare Diseases·Ellen SchatorjéEsther de Vries
Sep 20, 2011·The Annals of Otology, Rhinology, and Laryngology·Muneo NakayaKazuya Abe
May 10, 2017·American Journal of Medical Genetics. Part a·Chiyoko N InoueNobuko Tabata
Apr 20, 2021·Laryngoscope Investigative Otolaryngology·Noriko MorimotoMitsuru Kubota

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