Dysphagia surgery: Difference between revisions
Aditya Ganti (talk | contribs) |
m Bot: Removing from Primary care |
||
(2 intermediate revisions by 2 users not shown) | |||
Line 69: | Line 69: | ||
| colspan="2" |[[Tracheotomy]] or [[Tracheostomy]] | | colspan="2" |[[Tracheotomy]] or [[Tracheostomy]] | ||
| | | | ||
* Used for chronic aspiration | * Used for chronic [[aspiration]]. | ||
* The four major types of percutaneous tracheotomy:<ref name="pmid3996056">{{cite journal| author=Ciaglia P, Firsching R, Syniec C| title=Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report. | journal=Chest | year= 1985 | volume= 87 | issue= 6 | pages= 715-9 | pmid=3996056 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3996056 }} </ref><ref name="pmid9142576">{{cite journal| author=Fantoni A, Ripamonti D| title=A non-derivative, non-surgical tracheostomy: the translaryngeal method. | journal=Intensive Care Med | year= 1997 | volume= 23 | issue= 4 | pages= 386-92 | pmid=9142576 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9142576 }} </ref><ref name="BelangerAkulian2014">{{cite journal|last1=Belanger|first1=Adam|last2=Akulian|first2=Jason|title=Interventional Pulmonology in the Intensive Care Unit: Percutaneous Tracheostomy and Gastrostomy|journal=Seminars in Respiratory and Critical Care Medicine|volume=35|issue=06|year=2014|pages=744–750|issn=1069-3424|doi=10.1055/s-0034-1395504}}</ref><ref name="pmid2343371">{{cite journal| author=Griggs WM, Worthley LI, Gilligan JE, Thomas PD, Myburg JA| title=A simple percutaneous tracheostomy technique. | journal=Surg Gynecol Obstet | year= 1990 | volume= 170 | issue= 6 | pages= 543-5 | pmid=2343371 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2343371 }} </ref> | * The four major types of percutaneous tracheotomy:<ref name="pmid3996056">{{cite journal| author=Ciaglia P, Firsching R, Syniec C| title=Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report. | journal=Chest | year= 1985 | volume= 87 | issue= 6 | pages= 715-9 | pmid=3996056 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3996056 }} </ref><ref name="pmid9142576">{{cite journal| author=Fantoni A, Ripamonti D| title=A non-derivative, non-surgical tracheostomy: the translaryngeal method. | journal=Intensive Care Med | year= 1997 | volume= 23 | issue= 4 | pages= 386-92 | pmid=9142576 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9142576 }} </ref><ref name="BelangerAkulian2014">{{cite journal|last1=Belanger|first1=Adam|last2=Akulian|first2=Jason|title=Interventional Pulmonology in the Intensive Care Unit: Percutaneous Tracheostomy and Gastrostomy|journal=Seminars in Respiratory and Critical Care Medicine|volume=35|issue=06|year=2014|pages=744–750|issn=1069-3424|doi=10.1055/s-0034-1395504}}</ref><ref name="pmid2343371">{{cite journal| author=Griggs WM, Worthley LI, Gilligan JE, Thomas PD, Myburg JA| title=A simple percutaneous tracheostomy technique. | journal=Surg Gynecol Obstet | year= 1990 | volume= 170 | issue= 6 | pages= 543-5 | pmid=2343371 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2343371 }} </ref> | ||
** Ciaglia's dilation over guidewire | ** Ciaglia's dilation over guidewire | ||
Line 97: | Line 97: | ||
|Cricopharyngeal Myotomy<ref name="YipLeonard2006">{{cite journal|last1=Yip|first1=Helena T.|last2=Leonard|first2=Rebecca|last3=Kendall|first3=Katherine A.|title=Cricopharyngeal Myotomy Normalizes the Opening Size of the Upper Esophageal Sphincter in Cricopharyngeal Dysfunction|journal=The Laryngoscope|volume=116|issue=1|year=2006|pages=93–96|issn=0023-852X|doi=10.1097/01.mlg.0000184526.89256.85}}</ref><ref name="LuckeMeffert2008">{{cite journal|last1=Lucke|first1=C.|last2=Meffert|first2=O.|last3=Weiß|first3=D.|title=Cricopharyngeale Achalasie beim Schlaganfallpatienten|journal=DMW - Deutsche Medizinische Wochenschrift|volume=109|issue=20|year=2008|pages=792–795|issn=0012-0472|doi=10.1055/s-2008-1069275}}</ref> | |Cricopharyngeal Myotomy<ref name="YipLeonard2006">{{cite journal|last1=Yip|first1=Helena T.|last2=Leonard|first2=Rebecca|last3=Kendall|first3=Katherine A.|title=Cricopharyngeal Myotomy Normalizes the Opening Size of the Upper Esophageal Sphincter in Cricopharyngeal Dysfunction|journal=The Laryngoscope|volume=116|issue=1|year=2006|pages=93–96|issn=0023-852X|doi=10.1097/01.mlg.0000184526.89256.85}}</ref><ref name="LuckeMeffert2008">{{cite journal|last1=Lucke|first1=C.|last2=Meffert|first2=O.|last3=Weiß|first3=D.|title=Cricopharyngeale Achalasie beim Schlaganfallpatienten|journal=DMW - Deutsche Medizinische Wochenschrift|volume=109|issue=20|year=2008|pages=792–795|issn=0012-0472|doi=10.1055/s-2008-1069275}}</ref> | ||
| | | | ||
* Oblique, transverse, or S-shaped cervical incision is made preferably on the left side on the neck | * Oblique, transverse, or S-shaped cervical incision is made preferably on the left side on the [[neck]]. | ||
* Dissection the sternocleidomastoid muscle and carotid sheath are retracted | * Dissection the [[sternocleidomastoid muscle]] and [[carotid sheath]] are retracted. | ||
* Laryngopharynx is then mobilized by blunt dissection to expose the cricopharyngeus muscle | * [[Laryngopharynx]] is then mobilized by blunt dissection to expose the [[cricopharyngeus muscle]]. | ||
* Intraluminal esophageal | * Intraluminal esophageal foley catheter or the cuff of a second endotracheal tube inserted into the [[esophagus]] can be inflated to visualize the horizontal fibers of the [[Cricopharyngeus muscle|cricopharyngeus muscles]]. | ||
* Intact esophageal mucosa should be visualized after myotomy | * Intact [[esophageal]] mucosa should be visualized after [[myotomy]]. | ||
* Prevent fistula or mediastinitis any esophageal mucosa damage should be repaired | * Prevent [[fistula]] or [[mediastinitis]] any esophageal mucosa damage should be repaired. | ||
|- | |- | ||
|Percutaneous Endoscopic Gastrostomy<ref name="pmid6780678">{{cite journal| author=Gauderer MW, Ponsky JL, Izant RJ| title=Gastrostomy without laparotomy: a percutaneous endoscopic technique. | journal=J Pediatr Surg | year= 1980 | volume= 15 | issue= 6 | pages= 872-5 | pmid=6780678 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6780678 }} </ref> | |Percutaneous Endoscopic Gastrostomy<ref name="pmid6780678">{{cite journal| author=Gauderer MW, Ponsky JL, Izant RJ| title=Gastrostomy without laparotomy: a percutaneous endoscopic technique. | journal=J Pediatr Surg | year= 1980 | volume= 15 | issue= 6 | pages= 872-5 | pmid=6780678 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6780678 }} </ref> | ||
| | | | ||
*Stomach is insufflated with air | *[[Stomach]] is insufflated with [[air]]. | ||
*Using the transilluminated skin the stomach is punctured with a needle and a guidewire is introduced over the needle | *Using the transilluminated [[skin]] the [[stomach]] is punctured with a needle and a guidewire is introduced over the needle. | ||
*Guidewire and endoscope are then withdrawn through the mouth | *Guidewire and endoscope are then withdrawn through the [[mouth]]. | ||
*Gastrostomy tube is passed over the guidewire through the esophagus into the stomach | *[[Gastrostomy|Gastrostomy tube]] is passed over the guidewire through the esophagus into the [[stomach]]. | ||
|} | |} | ||
====Video==== | |||
{{#ev:youtube|y30FlOMUbFs}} | {{#ev:youtube|y30FlOMUbFs}} | ||
{{#ev:youtube|YjkZ6mQJ4JU}} | {{#ev:youtube|YjkZ6mQJ4JU}} | ||
Line 116: | Line 118: | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
Line 121: | Line 126: | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Otolaryngology]] | [[Category:Otolaryngology]] | ||
Latest revision as of 21:30, 29 July 2020
Dysphagia Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Dysphagia surgery On the Web |
American Roentgen Ray Society Images of Dysphagia surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Feham Tariq, MD [3]
Overview
Surgery is not the first-line treatment option for patients with dysphagia. Surgery is usually reserved for patients with either dysphagia leading to life-threatening aspiration and airway protection.
Surgical Treatment of Oropharyngeal Dysphagia
Surgical treatments are usually only recommended as a last resort and is dependent on the underlying cause of dysphagia. Surgical options for oropharyngeal dysphagia include:
- Endolaryngeal Stent
- Epiglottic Flap Laryngeal Closure
- Tracheoesophageal Diversion
- Laryngotracheal Separation
- Partial Cricoidectomy
- Subperichondrial Cricoidectomy
- Zenker's Diverticulectomy
- Tracheotomy or Tracheostomy
Surgical Options | Procedure | |
---|---|---|
Endolaryngeal Stent[1] | Weisberger and Huebsch Laryngeal stent | |
Eliachar and Nguyen laryngeal stent |
| |
Epiglottic Flap Laryngeal Closure[2][3] |
| |
Tracheoesophageal Diversion[4] |
| |
Laryngotracheal Separation[5] |
| |
Partial Cricoidectomy[6][7] |
| |
Subperichondrial Cricoidectomy[8] |
| |
Tracheotomy or Tracheostomy |
|
Other surgical options for oro-pharyngeal dysphagia include:
- Vocal fold augmentation/injection
- Thryoplasty medialization
- Arytenoid adduction
- Partial or total laryngectomy
- Laryngotracheal separation
- Supralaryngetomy
- Palatoplasty
- Cricopharyngeal Myotomy
- Percutaneous endoscopic gastrostomy
Surgical Treatment of Esophageal Dysphagia
- Surgical treatment of esophageal dysphagia is dependent on the underlying cause of dysphagia.
Surgical options | Procedure |
---|---|
Cricopharyngeal Myotomy[13][14] |
|
Percutaneous Endoscopic Gastrostomy[15] |
Video
{{#ev:youtube|y30FlOMUbFs}} {{#ev:youtube|YjkZ6mQJ4JU}}
References
- ↑ Eisele, David W. (1991). "Surgical approaches to aspiration". Dysphagia. 6 (2): 71–78. doi:10.1007/BF02493482. ISSN 0179-051X.
- ↑ Brookes GB, McKelvie P (1983). "Epiglottopexy: a new surgical technique to prevent intractable aspiration". Ann R Coll Surg Engl. 65 (5): 293–6. PMC 2494386. PMID 6614762.
- ↑ Castellanos, Paul F. (2016). "Method and Clinical Results of a New Transthyrotomy Closure of the Supraglottic Larynx for the Treatment of Intractable Aspiration". Annals of Otology, Rhinology & Laryngology. 106 (6): 451–460. doi:10.1177/000348949710600602. ISSN 0003-4894.
- ↑ Lindeman, Roger C. (1975). "DIVERTING THE PARALYZED LARYNX: A REVERSIBLE PROCEDURE FOR INTRACTABLE ASPIRATION". The Laryngoscope. 85 (1): 157–180. doi:10.1288/00005537-197501000-00012. ISSN 0023-852X.
- ↑ Snyderman, Carl H.; Johnson, Jonas T. (2016). "Laryngotracheal Separation for Intractable Aspiration". Annals of Otology, Rhinology & Laryngology. 97 (5): 466–470. doi:10.1177/000348948809700506. ISSN 0003-4894.
- ↑ Krespi, Yosef P.; Pelzer, Harold J.; Sisson, George A. (2016). "Management of Chronic Aspiration by Subtotal and Submucosal Cricoid Resection". Annals of Otology, Rhinology & Laryngology. 94 (6): 580–583. doi:10.1177/000348948509400611. ISSN 0003-4894.
- ↑ Krespi YP, Quatela VC, Sisson GA, Som ML (1984). "Modified tracheoesophageal diversion for chronic aspiration". Laryngoscope. 94 (10): 1298–301. PMID 6482627.
- ↑ Eisele, David W.; Seely, Daniel R.; Flint, Paul W.; Cummings, Charles W. (1995). "How I do it: Head and neck and plastic surgery: Subperichondrial cricoidectomy: An alternative to laryngectomy for intractable aspiration". The Laryngoscope. 105 (3): 322–325. doi:10.1288/00005537-199503000-00019. ISSN 0023-852X.
- ↑ Ciaglia P, Firsching R, Syniec C (1985). "Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report". Chest. 87 (6): 715–9. PMID 3996056.
- ↑ Fantoni A, Ripamonti D (1997). "A non-derivative, non-surgical tracheostomy: the translaryngeal method". Intensive Care Med. 23 (4): 386–92. PMID 9142576.
- ↑ Belanger, Adam; Akulian, Jason (2014). "Interventional Pulmonology in the Intensive Care Unit: Percutaneous Tracheostomy and Gastrostomy". Seminars in Respiratory and Critical Care Medicine. 35 (06): 744–750. doi:10.1055/s-0034-1395504. ISSN 1069-3424.
- ↑ Griggs WM, Worthley LI, Gilligan JE, Thomas PD, Myburg JA (1990). "A simple percutaneous tracheostomy technique". Surg Gynecol Obstet. 170 (6): 543–5. PMID 2343371.
- ↑ Yip, Helena T.; Leonard, Rebecca; Kendall, Katherine A. (2006). "Cricopharyngeal Myotomy Normalizes the Opening Size of the Upper Esophageal Sphincter in Cricopharyngeal Dysfunction". The Laryngoscope. 116 (1): 93–96. doi:10.1097/01.mlg.0000184526.89256.85. ISSN 0023-852X.
- ↑ Lucke, C.; Meffert, O.; Weiß, D. (2008). "Cricopharyngeale Achalasie beim Schlaganfallpatienten". DMW - Deutsche Medizinische Wochenschrift. 109 (20): 792–795. doi:10.1055/s-2008-1069275. ISSN 0012-0472.
- ↑ Gauderer MW, Ponsky JL, Izant RJ (1980). "Gastrostomy without laparotomy: a percutaneous endoscopic technique". J Pediatr Surg. 15 (6): 872–5. PMID 6780678.