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

Nobuaki Hiraki; Hideaki Suzuki; Tsuyoshi Udaka; Takanori Mori; Jun-ichi Okubo; Hiroki Koizumi; Yohei Kadokawa; Shoko Takeuchi; Chie Murakami; Seiko Suzuki; Akiko Takada

doi:10.5106/jjshns.18.229

Nobuaki Hiraki, Hideaki Suzuki, Tsuyoshi Udaka, Takanori Mori, Jun-ichi Okubo, Hiroki Koizumi, Yohei Kadokawa, Shoko Takeuchi, Chie Murakami, Seiko Suzuki, Akiko Takada

Author information

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

Keywords: laryngotracheal separation, tracheoesophageal diversion, videofluorography, pooling in the blind pouch, complications

JOURNAL FREE ACCESS

2008 Volume 18 Issue 3 Pages 229-234

DOI https://doi.org/10.5106/jjshns.18.229

Details

Abstract

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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