Intra-laryngeal endoprosthesis: an alternative therapeutic approach to surgical procedures of laryngeal exclusion

The uncertain results of aryepiglottopexy in our personal experience led us to develop, for patients with aspirations associated with the risk of seve re pneumonitis, three types of intralaryngeal endoprostheses (ILEP) under t he systematic cover of a tracheostomy. From September 1997 to May 1999, sev en protheses were implanted in six patients. It was not possible to restore the full range of laryngeal functions, i.e. deglutition, phonation and res piration. However, our results, that were obtained with an intracricoidal p rothesis closed at its upper end or equipped with a phonatory valve, are qu ite encouraging, even more so when in association with early alimentary re- education and support continuation of our trial. These ILEPs are simple to place, well tolerated, efficacious in preventing deglutition pneumonitis an d easy to remove. Furthermore, the reversibility of this bloodless procedur e facilitates the monitoring of a possible recovery of the laryngeal functi ons.