RESUMO
Severe dysphagia resulting in repeated aspirations and pneumonia are difficult to treat with swallowing therapy and surgical treatment is often required. Our study retrospectively reviews our experience with 19 such cases operated by laryngeal suspension and laryngotracheal separation. Restoration of oral nutrition was possible in 45% of laryngeal suspension cases and in 75% of laryngotracheal separation operations. These surgical techniques prevent severe aspirations while conserving phonation, contrarily to total laryngectomy. Tracheocutaneous fistulas were frequent, especially after radiation, implying that the surgical technique should be modified in the future.
Assuntos
Aspiração Respiratória/cirurgia , Idoso , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/reabilitação , Transtornos de Deglutição/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Terapia Nutricional/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/reabilitação , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Aspiração Respiratória/epidemiologia , Aspiração Respiratória/reabilitação , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
The tuberculosis of the ear is rare. In most cases, the clinical picture resembles that of a chronic otitis media. The bacteriological exams are seldom positive at the earliest stage of the disease. The two reported cases of this paper illustrate the difficulties of the diagnosis. In the first one, the diagnosis was made although the bacteriological proof could not be obtained, based on other exams. In the second one, it was made on the basis of a positive PCR of the tissues removed during a radical mastoidectomy. The literature on the various clinical aspects of the tuberculosis of the ear is reviewed.
