[Surgical rehabilitation of neuromuscular swallowing disorders with special regard to cricopharyngeal myotomy and glottopexy].

UNLABELLED: Surgical Rehabilitation of Neuromuscular Swallowing Disorders with Special Regard to Cricopharyngeal Myotomy and Glottopexy.

BACKGROUND

The surgical rehabilitation of patients with swallowing disorders caused by neuromuscular insufficiency with life-threatening aspiration presents a special challenge to the ENT-surgeon.

METHODS

In a period of 5 years we decided on a surgical treatment in altogether 12 patients with paralytical dysphagia. In 6 patients we combined a cricopharyngeal myotomy with a complete closure of the glottis, in 5 patients we performed a sole cricopharyngeal myotomy. In another patient we restricted ourselves to glottopexy only.

RESULTS

In all cases the dysphagia giving rise to the surgical intervention was regredient so far that the removal of the percutan endoscopic gastrostomy postsurgically was possible. 3 special cases are presented in detail.

DISCUSSION: The main part of the therapy is the subtle and complete cricopharyngeal myotomy. Particulary good results are available with a combination of the latter with a reversible glottopexy.

CONCLUSIONS

After the failure of conservative therapy the indication for a surgical treatment should be made on a large scale.