Laryngectomy for Intractable Aspiration in Progressive Degenerative Neuron Diseases.

A total laryngectomy was conducted to prevent intractable aspiration in ten cases of amyotrophic lateral sclerosis and three cases of multiple system atrophy. Such patients eventually lose their articulating function, and if left untreated, we feared that our patients would suffer asphyxiation and repeated aspiration pneumonia due to accidental aspiration. If treated by a surgical procedure, on the other hand, it can be anticipated that a patient's life expectancy will be at least one year. Therefore, our patients all agreed to undergo a total laryngectomy.The postoperative recovery was uneventful, and every patient was eventually permitted to try oral feeding. Oral feeding became viable for an extended period in six patients, while the others needed nasogastric or gastrostomy tube feeding for a maintenance of adequate nutrition. With the possibility of aspiration eliminated, these patients were able to eat and sleep without fear. Many extended their sphere of activities and improved their QOL.The present experiences revealed that among the surgical procedures to separate the airway from the digestive tract to prevent intractable aspiration in progressive degenerative neuron diseases, a total laryngectomy produces a reliable effect and therefore should be recommended.