The Extended Role of Total Laryngectomy in Patients with Severe Neuromuscular Disabilities

Abstract

Amongst the myriad of problems that patients with severe neurodisability encounter is that of recurrent airway obstructions and intractable aspiration pneumonias due to dysfunction of the protective mechanism of the larynx. It can result in significant morbidity and mortality and represents a large burden for carers and patient alike. Here, we describe the use of total laryngectomy as a surgical option for these patients. Case discussion of a 24 year old male with severe cerebral palsy suffering from recurrent episodes of airway obstruction and aspiration pneumonia. This patient underwent a total laryngectomy with good effect. In addition to relieving his symptoms, it greatly eased the daily management of his airway by his carers. In the severely disabled patient with recurrent aspiration pneumonias, total laryngectomy may present as a viable option, especially in those patients who have been previously incapable of effective verbal communication.

Keywords

• Aspiration pneumonia, airway obstruction, neuromuscular disorder, laryngectomy

The Extended Role of Total Laryngectomy in Patients with Severe Neuromuscular Disabilities

Öz

Şiddetli nörolojik bozukluğu olanlarda sayısız probler arasında tekrarlayan hava yolu tıkanmaları ve larinks koruyucu mekanizma disfonksiyonu nedeniyle dirençli aspirasyon pnömonileri yer almaktadır. Burada, bu hastalar için cerrahi bir seçenek olarak total larenjektomi kullanımını tarif edilmektedir. Olgu hava yolu tıkanıklığı ve aspirasyon pnömonisi ataklarıyla gelen ciddi serebral palsili 24 yaşındaki erkek idi. Tekrarlayan aspirasyon pnömoniler ile gelen, özellikle etkili sözlü iletişimin daha önceden aciz olmuş ağır özürlü hastalarda total larenjektomi görülebilir bir seçenek olarak sunulubailir

Anahtar Kelimeler

• Aspirasyon pnömonisi, havayolu tıkanıklığı, nöromuskuler bozukluk, larenjektomi

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