Osako Miho, Saigusa Hideto, Takeuchi Chisen, Minatogawa Mitsuko, Mochizuki Yoko
Department of Neurology, Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled.
Department of Otolaryngology, Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled.
Rinsho Shinkeigaku. 2020 Mar 31;60(3):193-199. doi: 10.5692/clinicalneurol.cn-001344. Epub 2020 Feb 26.
Three patients with neurodegenerative diseases who had developed repeated aspiration pneumonia underwent laryngeal closure, a surgical procedure at the larynx to prevent aspiration. None of these patients have developed aspiration pneumonia since the procedure. One patient needed endoscopic suction and cough assist machine to clear thick sputum, because tracheostomy bypassed the upper airway and so prevented moisturization of inhaled air. While two patients achieved freedom from tracheal cannulation, one needed continued cannulation because of narrowing of the stoma due to improvements in the nutritional condition. One patient was able to resume oral intake. Although the right timing to perform the procedure and optimal care along with long-term observation are important, laryngeal closure is an effective option for patients with neurodegenerative diseases to prevent recurrent aspiration pneumonia.
三名患有神经退行性疾病且反复发生吸入性肺炎的患者接受了喉关闭术，这是一种在喉部进行的防止误吸的外科手术。自该手术后，这些患者均未再发生吸入性肺炎。一名患者需要通过内镜吸引和咳嗽辅助机器来清除浓稠痰液，因为气管造口术绕过了上呼吸道，从而阻止了吸入空气的湿润。两名患者成功摆脱了气管插管，一名患者由于营养状况改善导致造口狭窄而需要继续插管。一名患者能够恢复经口进食。尽管进行该手术的正确时机、最佳护理以及长期观察很重要，但喉关闭术对于患有神经退行性疾病的患者预防复发性吸入性肺炎是一种有效的选择。
