Chapter 66 : Chronic aspiration

Question 1

Most common cause of intractable aspiration in adults

Answer 1

cerebrovascular accident (with subsequent lower cranial nerve palsies)

Question 2

3 major functions of the larynx

Answer 2

respiration, phonation, airway protection

Question 3

It is the laryngeal penetration of secretions such as saliva, ingested liquids or solids, or refluxed gastric contents below the level of the true vocal cords

Answer 3

aspiration

Question 4

Cough does not occur after laryngeal penetration

Answer 4

silent aspiration

Question 5

In pediatric patients, chronic aspiration is most commonly related to _____

Answer 5

severe neurologic dysfunction (resulting from cerebral palsy, anoxic encephalopathy, sequelae of neurologic trauma or surgery, tracheoesophageal fistula, or other severe congenital or acquired neurologic disorders)

Question 6

Diagnostic which provides information about the precise physiologic nature of aspiration and swallowing disturbance and about the severity of aspiration

Answer 6

videofluoroscopic swallowing study

Question 7

Person who described a modified barium swallow study in which small amounts of barium are used because of the risk of aspiration

Answer 7

Logemann

Question 8

Alternative to videofluoroscopy for the evaluation of dysphagia

Answer 8

FEES (functional endoscopic evaluation of swallowing)

Question 9

Discontinued when presented with a patient with chronic aspiration

Answer 9

all oral intake

Question 10

Before 1970, it was considered the surgical procedure of choice for management of chronic aspiration

Answer 10

laryngectomy (narrow-field laryngectomy)

Question 11

It is an option for definitive surgical separation of the upper respiratory and digestive tracts when recovery of function is not expected

Answer 11

subperichondreal crocoidectomy

Question 12

This can be done for the prevention of aspiration in patients who required total glossectomy for advanced carcinoma of the tongue

Answer 12

vertical laryngoplasty

Question 13

This procedure for chronic aspiration was devised with the objective of developing a reliable surgical technique that would control aspiration for an indefinite period while preserving the larynx and the integrity of the recurrent laryngeal nerves. The procedure was designed to be reversible if healthy laryngeal protective function returned

Answer 13

tracheoesophageal diversion (TED)

Question 14

Most common complication seen with laryngotracheal separation (LTS)

Answer 14

formation of a tracheocutaneous fistula

Question 15

2 most dependable of the reversible techniques for preventing chronic aspiration

Answer 15

TED (tracheoesophageal diversion) and LTS (laryngotracheal separation)

Question 16

Options considered for chronic aspiration if there is no chance of recovery of neurologic function

Answer 16

subperichondreal cricoidectomy and narrow-field laryngectomy