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Open Access 01-12-2022 | Amyotrophic Lateral Sclerosis | Research article

Long-term outcomes after surgery to prevent aspiration for patients with amyotrophic lateral sclerosis

Authors: Temma Soga, Naoki Suzuki, Kengo Kato, Ai Kawamoto-Hirano, Yuko Kawauchi, Rumiko Izumi, Masaya Toyoshima, Shio Mitsuzawa, Tomomi Shijo, Kensuke Ikeda, Hitoshi Warita, Yukio Katori, Masashi Aoki, Masaaki Kato

Published in: BMC Neurology | Issue 1/2022

Abstract

Background

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons selectively. In particular, weakness in respiratory and swallowing muscles occasionally causes aspiration pneumonia and choking, which can be lethal. Surgery to prevent aspiration, which separates the trachea and esophagus, can reduce the associated risks. Central-part laryngectomy (CPL) is a relatively minimally invasive surgery to prevent aspiration. No studies have been conducted on the long-term outcomes of surgery to prevent aspiration in patients with ALS. This case series aimed to determine the long-term outcomes of surgery to prevent aspiration and the use of a continuous low-pressure aspirator in patients with ALS by evaluating the frequency of intratracheal sputum suctions performed per day, intra- and postoperative complications, oral intake data, and satisfaction of patients and their primary caregiver to predict improvement in patients’ quality of life (QOL).

Methods

We report a case series of six patients with ALS who underwent CPL along with tracheostomy to prevent aspiration between January 2015 and November 2018. We evaluated their pre- and postoperative status and administered questionnaires at the time of last admission to the patients and their primary caregivers.

Results

The mean follow-up period after CPL was 33.5 months. Aerophagia was a common postoperative complication. The use of a continuous low-pressure aspirator resulted in reduced frequency of intratracheal sputum suctions. All cases avoided aspiration pneumonia. Oral intake was continued for 2–4 years after the tracheostomy and CPL. The satisfaction levels of the patient and primary caregiver were high.

Conclusion

Our case series suggests that the use of a continuous low-pressure aspirator in patients undergoing CPL improves oral intake and reduces the frequency of intratracheal sputum suctions, which improves the QOL of patients with ALS and their families and caregivers. CPL and continuous low-pressure aspiration should be considered as a management option for ALS with significant bulbar and respiratory muscle weakness/dysfunction.

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Title: Long-term outcomes after surgery to prevent aspiration for patients with amyotrophic lateral sclerosis
Authors: Temma Soga
Naoki Suzuki
Kengo Kato
Ai Kawamoto-Hirano
Yuko Kawauchi
Rumiko Izumi
Masaya Toyoshima
Shio Mitsuzawa
Tomomi Shijo
Kensuke Ikeda
Hitoshi Warita
Yukio Katori
Masashi Aoki
Masaaki Kato
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Amyotrophic Lateral Sclerosis
Aspiration Pneumonia
Expectoration
Foreign Body Aspiration
Foreign Body Aspiration
Aspiration
Laryngectomy
Tracheostomy
Published in: BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-022-02619-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term outcomes after surgery to prevent aspiration for patients with amyotrophic lateral sclerosis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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