Laryngotracheal Separation for Intractable Aspiration

Intractable aspiration may be a life-threatening problem for patients with altered laryngeal function secondary to neurologic disorders or abnormal laryngeal anatomy. Multiple surgical procedures have been devised to deal with this problem. An effective technique involves the creation of a tracheostoma and closure of the larynx at the first or second tracheal ring. Laryngotracheal separation is relatively easy to perform and potentially reversible. Experience with this technique in six patients who required laryngeal separation for intractable aspiration is described. The procedure was successful in preventing aspiration and recurrent pneumonia associated with neurologic dysfunction, unresectable neoplasm, and conservation laryngeal surgery. One patient of one has had a successful reconstruction.