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Treatment of intractable aspiration – combined open medialisation thyroplasty with intra-glandular botulinum toxin injection
Published online by Cambridge University Press: 11 November 2024
Abstract
Objective
This paper aims to introduce our combined approach, which provides definitive treatment for intractable aspiration while preserving phonation and highlights the importance of performing both procedures together.
Methods
We describe a case of intractable aspiration requiring a nasogastric tube and a tracheostomy tube. We propose a combined technique consisting of an open medialisation thyroplasty with intra-operative, intra-glandular botulinum toxin injection. The thyroplasty procedure medialises the left vocal fold to overcome glottic insufficiency. Botulinum toxin injection reduces salivary flow and prevents excessive pooling.
Results
The patient was followed up for twelve months. Video fluoroscopy demonstrated no evidence of aspiration. The patient was allowed a regular oral diet and decannulated two months post-operatively.
Conclusion
This paper demonstrates the feasibility of our combined approach as a viable treatment option for intractable aspiration, particularly in patients with a strong desire for vocalisation. The cases must be selected carefully to ensure a favourable outcome.
Information
- Type
- Short Communications
- Information
- Copyright
- © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.
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