Aspiration pneumonia resulting from cerebrovascular or neurodegenerative disorders could be a fatal disease. In patients with repeated episodes of aspiration pneumonia despite conservative management, surgeries to prevent aspiration, such as laryngectomy and laryngotracheal separation, may be indicated.
Here, we report two patients with intractable aspiration pneumonia in whom we performed laryngotracheal separation using the B-type tracheal flap method, with no postoperative complications. Both patients were relieved from the frequent sputum-sucking after the surgery, which resulted in an improved QOL for both the patients themselves and their caregivers.
The tracheal flap method is less invasive than Lindeman surgery, because the membranous portion of the trachea is left intact in this method, whereas the trachea is cut circumferentially in Lindeman surgery; this could lead to the shorter operation time and lower incidence of postoperative complications of the tracheal flap method. Furthermore, in this method, in which the skin flap is sutured directly to the tracheal membrane, a wider tracheal stoma can be obtained, leading to the possibility of tracheotomy-tube-free management. Thus, this surgery is beneficial to improve the QOL of both patients with repeated episodes of aspiration pneumonia and their caregivers.