What is the role of surgery in the treatment of dysphagia?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Surgery for chronic aspiration may involve the following:

  • Medialization: This helps to restore glottic closure and subglottic pressure during the swallow

  • Laryngeal suspension: The larynx is in a relatively protected position under the tongue base

  • Laryngeal closure: This may be performed to close the glottis off, in this way protecting the airway at the expense of phonation

  • Laryngotracheal separation-diversion: This procedure may be done to separate the airway from the alimentary tract

In the acute setting, when the need to decrease the aspiration of secretions is urgent, a tracheostomy is a simple and effective choice. However, in a chronic situation in which the patient has no likelihood of recovering a safe swallow and voice, laryngectomy is the most effective choice. In patients for whom recovery of voice and swallowing function is uncertain but aspiration of secretions is life threatening, temporary laryngeal closure by a diversion procedure can be used.

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