Pooling in the tracheal blind pouch after laryngotracheal separation for recurrent aspiration pneumonia

DOI 1 Citations 23 References
  • Hiraki Nobuaki
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environ-mental Health
  • Suzuki Hideaki
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environ-mental Health
  • Udaka Tsuyoshi
    Department of Otorhinolaryngology, Kyushu Rosai Hospital
  • Mori Takanori
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environ-mental Health
  • Okubo Jun-ichi
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environ-mental Health
  • Koizumi Hiroki
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environ-mental Health
  • Kadokawa Yohei
    Department of Otorhinolaryngology, Kyushu Rosai Hospital
  • Takeuchi Shoko
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environ-mental Health
  • Murakami Chie
    Department of Pedi-atrics, Kitakyushu Rehabilitation Center for Children with Disabilities
  • Suzuki Seiko
    Department of Pedi-atrics, Kitakyushu Rehabilitation Center for Children with Disabilities
  • Takada Akiko
    Department of Pedi-atrics, Kitakyushu Rehabilitation Center for Children with Disabilities

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Other Title
  • 喉頭気管分離術後の気管盲端部貯留

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We examined the pooling in the tracheal blind pouch created by laryngotracheal separation. Eight patients aged 14-56 years with recurrent aspiration pneumonia underwent laryngotracheal separation according to the modified Lindeman's procedure. Videofluorography was performed postoperatively, and X-rays of the neck were taken 6 and 24 hr later, and then every 24 hr until the contrast medium cleared away. The clearance time of the contrast medium was ≤ 24 hr in 5 patients, ≤ 48 hr in one patient, and ≤ 72 hr in 2 patients. Patients with better swallowing function tended to show shorter clearance time. One patient developed wound dehiscence of the tracheal blind pouch and needed reoperation, but late complications such as infections of the pouch were not observed in any of the patients. Based on the present results, infections in the blind pouch are prevented presumably by slow but continuous replacement of pooling material. We conclude that laryngotracheal separation is as reliable and effective as tracheoesophageal diversion for the treatment of intractable aspiration.

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