The following clinical data concerning the surgical procedure were examined: operation time, time until oral intake, videoflu-orographic study, and surgical complications. The medical management for aspiration including feeding condition was also examined before and after surgery. Scores of aspiration pneumonia, BMI, laboratory data, the Barthel Index, the SDS, the face scale, and the VAS were determined 1 month before surgery and again 14.5 ± 6.7 months (range, 8 to 25 months) after surgery. All patients were clinically stable 1 month before surgery and did not suffer from respiratory failure caused by pneumonia. In addition, the SDS, the face scale, and the VAS of families were evaluated before and after surgery.
Data are shown as means ± SD. The differences before and after surgical therapy were compared using the Wilcoxon signed-rank test. A value of p < 0.05 was considered significant. Further multiple tests of clinical data were determined using Bonferroni/ Dunn test. canadian health&care mall
Table 1 summarizes the characteristics before surgical therapy of patients participating in this study. The BMI of all patients was very low (16.9 ± 3.5 kg/m2), and control of aspiration pneumonia was also very poor. All patients had intractable aspiration and suffered from recurrent aspiration pneumonia. Phonation was poor in all patients; therefore, they could not communicate well with others by speech. Preoperative feeding conditions of patients were as follows: NTF in five, IVH in four, and percutaneous endoscopic gastrostomy (PEG) in three. We discontinued PEG before surgery in all three because of aspiration and peristomal wound infection.
Clinical data of surgical procedures are shown in Table 2. Mean operation time was 201 ± 47 min.
The time until oral intake was 18 ± 6 days. Video-fluorography revealed that no patient suffered from aspiration after surgery. There were no surgical complications in any patient.
Table 1—Characteristics of Study Population
|PatientNo.||Age;yr||Sex||BMI Before Operation,kg/m2||Underlying Disease||Score of Aspiration Pneumonia!||PhonationCondition!||Preoperative Feeding Condition|
|1||73||M||23.3||Cerebrovascular disease||3||2||PEG, IVH|
|2||62||M||18.1||Oropharyngeal dysynchrony, bedridden||3||2||NTF, IVH|
|4||77||M||12.0||Oropharyngeal dysynchrony, laryngeal cancer after laser surgery and irradiation||3||3||NTF|
|5||52||M||17.2||Cerebrovascular disease||3||3||PEG, NTF, IVH|
|6||63||M||14.8||Amyotrophic lateral sclerosis||3||3||PEG, IVH|
|7||64||M||16.8||Muscular dystrophy, oropharyngeal muscle atrophy||2||2||NTF|
Table 2—Clinical Data for the Surgical Procedure
|PatientNo.||OperationTime,min||Time Until Oral Intake, d||Aspiration Evaluated byVideofluorography|