Surgical Interventions as a Treatment Option for Severe Dysphagia with Intractable Aspiration: Concept, Indications, and Efficacy

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Published Sep 20, 2022
DOI: https://doi.org/10.18103/mra.v10i9.3113

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Main Article Content

Masamitsu Hyodo
Department of Otolaryngology, Kochi Medical School Kohasu, Okou-cho, Nankoku, Kochi 783-8505, Japan
Asuka Nagao
Department of Otolaryngology, Kochi Medical School Kohasu, Okou-cho, Nankoku, Kochi 783-8505, Japan
Kaori Tanaka
Department of Otolaryngology, Ehime University School of Medicine Shitsukawa, Toon-City, Ehime 791-0295, Japan

Abstract

The incidence of dysphagia is increasing, particularly among the elderly according to varied of causes. Patients with severe dysphagia are unable to take food orally and are at risk for life-threatening aspiration pneumonia. Treatments for swallowing disorders focus on restoring oral food intake and preventing recurrent aspiration pneumonia. Therefore, swallowing rehabilitation and food texture modifications are essential. However, in cases with severe or progressive dysphagia, these conservative treatments may not restore oral feeding and prevent intractable aspiration pneumonia. In these cases, surgical interventions has recently been attracted as an alternative treatment option. In this article, we present its concept, indications, and efficacy.


Surgeries to restore swallowing function address impaired pharyngolaryngeal motor function during the pharyngeal swallowing stage while preserving laryngeal functions. These procedures include laryngeal elevation, cricopharyngeal myotomy, and vocal cord medialization. Meanwhile, aspiration prevention surgeries reduce the risk of aspiration pneumonia by separating the lower respiratory tract from the pharynx and larynx. These procedures include total laryngectomy, laryngotracheal separation, and glottal closure; although they do not spare laryngeal functions, they prevent aspiration pneumonia completely, improve quality of life, and reduce the burden on caregivers. Clinicians should be aware of surgical interventions as a possible treatment option for intractable dysphagia. Establishment and popularization of the surgical indications are the future issues.

Article Details

How to Cite
HYODO, Masamitsu; NAGAO, Asuka; TANAKA, Kaori. Surgical Interventions as a Treatment Option for Severe Dysphagia with Intractable Aspiration: Concept, Indications, and Efficacy. Medical Research Archives, [S.l.], v. 10, n. 9, sep. 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3113>. Date accessed: 02 may 2024. doi: https://doi.org/10.18103/mra.v10i9.3113.
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Issue
Vol 10 No 9 (2022): Vol.10 Issue 9 September 2022
Section
Research Articles

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