Introduction of new laryngeal closure methods for patients with intractable aspiration.

The aging population in Japan has recently resulted in a rapid increase in elderly individuals. Airway management is thus being required more and more often. Aspiration pneumonia is a life-threatening problem among patients with swallowing problems. Several new surgical methods of laryngeal closure that are easier and safer than previous methods have been developed. Among these new methods, we have performed the Kano method as closure of the larynx using double flaps of the divided craniad vocal folds and the divided caudad vocal folds with partial resection of the thyroid and cricoid cartilages for patients with intractable aspiration. We encountered minor leakage in two patients, but these soon closed spontaneously. This procedure is less invasive than other methods such as total laryngectomy and tracheal separation and has great advantages in terms of low blood loss and short duration of the operation.

[Role of clinical laboratory in Japanese general hospital for equilibrium functional tests].

Recent automation in clinical laboratories affords healthcare providers with numerous options in terms of physiological tests. However, the role of the clinical laboratory in the field of equilibrium functional tests is not clearly defined. Therefore, we conducted a questionnaire survey to define the role of clinical laboratories in general hospitals. We present the results of our investigation and the approach employed by the clinical laboratory of our hospital. Rates of healthcare providers desiring the conduct of equilibrium functional tests by clinical laboratories were 78% and 70% in otolaryngology and neurosurgery departments, respectively; moreover, 92% of technologists from clinical laboratories responded that an equilibrium functional test can be performed upon request. Furthermore, 84% of clinical laboratory staff members and 77% of staff from neurosurgery departments agreed that implementation of a system allowing each department to request equilibrium functional tests from the clinical laboratories is necessary. This finding was indicative of the high demand for equilibrium functional tests by clinical laboratories. Therefore, equilibrium functional tests offered by clinical laboratories not only reduce the workload of the otolaryngology department, but also result in a major contribution with respect to management of the entire hospital in terms of high quality examination findings and allocation of healthcare providers in other departments.