[Surgical management for intractable aspiration in handicapped children].

Intractable aspiration is a life-threatening medical problem. Sixteen patients with intractable aspiration underwent surgical management. Their underlying diseases were cerebral palsy (n = 6), degenerative diseases (n = 5), acquired hypoxic ischemic encephalopathy (n = 4), and congenital myopathy (n = 1). Laryngotracheal separation was performed in nine patients with median age of 2 years 6 months (range: 7 mo - 13 y 5 mo), and laryngectomy was performed in seven with median age of 7 years 4 month (range: 1 y 6 mo - 17 y 1 mo). Surgical interventions were effective in all patients with respiratory distress. The most common complication was increased drawling in six patients, who recovered within 6 months of clinical follow-up. Other complications were tracheal granulations (n = 4), bleeding (n = 2), narrowing of the tracheal hole (n = 2), tracheomalacia (n = 2), ruptured suture (n = 1), and tracheal abscess (n = 1). Considering the underlying diseases and age, surgical management for intractable aspiration should be performed at appropriate timing.