TY - JOUR T1 - The Extended Role of Total Laryngectomy in Patients with Severe Neuromuscular Disabilities TT - The Extended Role of Total Laryngectomy in Patients with Severe Neuromuscular Disabilities AU - Vijendren, Ananth AU - Jablenska, Liliana AU - Kothari, Prasad AU - Trinidade, Aaron PY - 2014 DA - September DO - 10.15197/sabad.1.11.69 JF - European Journal of General Medicine PB - Sağlık Bilimleri Araştırmaları Derneği WT - DergiPark SN - 1304-3889 VL - 11 IS - 3 LA - en AB - 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. KW - Aspiration pneumonia KW - airway obstruction KW - neuromuscular disorder KW - laryngectomy N2 - 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 CR - Hawthrone M. Conservative Laryngectomy (An effective treatment for severe aspiration pneumonia in motor neu- ron disease). J Laryngol Otol 1987;101:293-85. 2. Aspiration Pneumonia–Medscape CR - http://emedicine.medscape.com/article/296198 CR - overview#aw2aab6c29 – Accessed 2012 CR - Blitzer A, Brin M F, Ramig L. Neurological Disorders of the Larynx. Thieme Medical Publishers 2009:89-90 CR - Neuromuscular Disorders – Medline Plus http://www. nlm.nih.gov/medlineplus/neuromusculardisorders.html - Accessed 2012 CR - Montgomery WW. Surgery to prevent aspiration. Arch Otolaryngol. 1975;101:679-82. CR - Brookes G B, McKelvie P. Epiglottopexy: a new surgical technique to prevent intractable aspiration. Ann R Coll Surg Engl 1983;65:293–6. CR - Gelfand YM, Duncan NO, Albright JT, et al. Laryngotracheal separation surgery for intractable aspiration: our expe- rience with 12 Patients. Int J Pediatr Otorhinolaryngol 2011;75:931-4. CR - Francis DO, Blumin J, Merati A. Reducing fistula rates following laryngotracheal separation. Ann Otol Rhinol Laryngol 2012;121:151-5. CR - Tracheostomy – National Heart Lung and Blood Institute, People Science Health, US Department of Health and Human health-topics/topics/trach/ - Accessed 2012 Reference. CR - http://www.nhlbi.nih.gov/health/ CR - Takano Y, Suga M, Sakamoto O et al. Satisfaction of pa- tients treated surgically for intractable aspiration. Chest 1999;116:1251-6. UR - https://doi.org/10.15197/sabad.1.11.69 L1 - http://dergipark.org.tr/tr/download/article-file/61194 ER -