Epiglotto‐Aryepiglottopexy: A surgical procedure for severe aspiration

Abstract

The loss of the protective function of the larynx is a severe complication of major ablative procedures in the upper aerodigestive tract and of certain severe neurological disorders. This may result in chronic life-threatening aspiration. Anterior pharyngotomy was used to perform epiglotto-aryepiglottopexy in four patients. The aim of this procedure is to close the laryngeal inlet and thus prevent aspiration without permanent loss of speech. In two of the patients, it was necessary to reoperate because of partial detachment of the epiglottis. This was performed successfully using the endoscopic approach. As a result, three patients have no aspiration and one has mild aspiration following epiglotto-aryepiglottopexy.

Position paper of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the German Society of Phoniatrics and Pediatric Audiology – Current state of clinical and endoscopic diagnostics, evaluation, and therapy of swallowing disorders in children

“…Endoscopically, the epiglottis can be lowered in a dorsal direction to protect the laryngeal entrance by applying a technique described by Laurian [ 250 ] or, in a modified manner, by bilaterally transecting the plicae pharyngoepiglotticae and disconnecting the plica glossoepiglottica from the tongue (Figure 27 (Fig. 27) ) [ 35 ].…”