A NEW EPIGLOTTOPLASTY PROCEDURE FOR THE TREATMENT OF INTRACTABLE ASPIRATION

Intractable aspiration may require diversion of the airway from the ph arynx. The epiglottoplasty procedure involves suturing the epiglottis onto the perimeter of the larynx without creating resistance to the na tural lines of force of the epiglottic cartilage. The procedure starts by an anterior subhyoid pharyngotomy. The epiglottis is released from the pre-epiglottic space and the thyroepiglottic ligament is sectione d. The disinsertion is completed in the laryngeal lumen by sectioning the epiglottis on each side by following its edges. The pharyngoepiglo ttic folds are preserved so as to serve as the rotational axis for the freed epiglottis. The petiole of the epiglottis is anchored to the po sterior commissure and the free edge of the epiglottis above the ala a nd the angle of the thyroid cartilage, while the lateral sides of the suprahyoid epiglottis are sutured to the superior part of the arytenoi ds. This procedure was performed successfully in three patients with i ntractable aspiration.