Staple-assisted laryngectomy for intractable aspiration☆

Staple-assisted laryngectomy is a unique method previously reported by Lukyanchenko to prevent wound contamination by using a stapling device for suturing pharyngeal defects in total laryngectomy. We have modified his method and applied it to prevent a postoperative pharyngocutaneous fistula in the treatment of intractable aspiration. In contrast to laryngeal cancer patients, a combined use of an intraluminal light to guide the dissection and laryngofissure to pull the epiglottis can be used to facilitate the use of the stapling device. For most patients with intractable aspiration who have significant malnutrition and drug-resistant bacterial colonization of the pharynx, this method offers certain advantages. This report describes our successful experience with this method in the management of patients with intractable aspiration. (Am J Otolaryngol 2003;24:70-74. Copyright 2003, Elsevier Science (USA). All rights reserved.)