Einseitige erweiterte Medialisierungs-thyroplastik: Therapie der Kompletten Aspiration nach Laserchirurgischer Resektion und Strahlentherapie des Larynxkarzinoms

Total aspiration is a rare complication after extended laser surgery for laryngeal cancer with adjuvant radiotherapy. Two patients with long-standing total aspiration after laser surgery with radiotherapy despite intensified swallowing therapy were treated with an extended medialization thyroplasty. Postoperatively, both patients were able to swallow food and liquids without aspiration. One patient no longer has a gastrostomy tube and has been free from aspiration with normal oral food intake for 3 years. The second patient, with a tiny mucosal scar perforation, developed an abscess 2 months after surgery and needed revision surgery, with a subsequent return of aspiration. The second patient's complication stresses the significance of an intact endolaryngeal scar because of the well-known prolonged healing of mucosa in the irradiated larynx. In our opinion, the potential benefits of medialization thyroplasty outweigh the risk of significant complications, especially after irradiation.