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Tracheoesophageal diversion improves oral uptake of food: a retrospective study

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Tracheoesophageal diversion (TED) is an effective therapeutic procedure for intractable aspiration. In this study, we performed TED in cases of intractable aspiration and/or repetitive pneumonia, investigated the main route of nutritional uptake after the procedure, and evaluated the swallowing method using videofluoroscopy. We also evaluated the validity of TED for treating intractable aspiration.

Methods

We retrospectively reviewed 44 patients (30 male and 14 female patients; median age, 55 years; range 15–85 years) who underwent TED for the treatment of intractable aspiration between January 2008 and December 2017. We examined the route of nutritional uptake before and after the operation and performed videofluoroscopy to detect the swallowing method after the operation.

Results

The percentage of patients with oral intake increased from 21% (9/44) before TED to 56% (25/44) within 1 month after TED (p < 0.01); this percentage included patients with poor preoperative swallowing function. Overall, 60% patients who were able to communicate and mobilize using a wheelchair as well as 92% patients who were able to communicate and mobilize in the supine position were able to consume food orally. We subsequently performed videofluoroscopy in 24 of the 25 patients with oral intake and assessed the passage route of the contrast agent, which was found to move through the laryngeal route in 54% of these patients.

Conclusion

TED may be suitable for the treatment of intractable aspiration and can improve oral intake, particularly in patients with good mobility and communication ability.

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Authors and Affiliations

  1. Fukuoka Sanno Hospital, 3-6-45, Momochihama, Sawara-ku, Fukuoka, 814-0001, Japan

    Kazuo Adachi, Toshiro Umezaki, Naoko Matsubara, Yogaku Lee, Takashi Inoguchi & Yoshikazu Kikuchi

Authors
  1. Kazuo Adachi
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  2. Toshiro Umezaki
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  3. Naoko Matsubara
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  4. Yogaku Lee
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  5. Takashi Inoguchi
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  6. Yoshikazu Kikuchi
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection and analysis were performed by KA, TU, and YK. The first draft of the manuscript was written by KA, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kazuo Adachi.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Kyushu University-certified institutional review board for clinical trials, number 15864) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Adachi, K., Umezaki, T., Matsubara, N. et al. Tracheoesophageal diversion improves oral uptake of food: a retrospective study. Eur Arch Otorhinolaryngol 277, 2293–2298 (2020). https://doi.org/10.1007/s00405-020-05988-8

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  • DOI: https://doi.org/10.1007/s00405-020-05988-8

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