Study on Postoperative Diastasis of Epiglottic Closure Procedure (biller Method)

Among surgical treatment for severe aspiration pneumonia, the epiglottic closure procedure, which makes phonation possible, is very useful, but sewing the epiglottis has resulted in postoperative diastasis, and improvement of restitution by epiglottic cartilage elasticity is a problem, so we made reference of configuration and power of restitution of epiglottis clear. We classified epiglottis configurations into flat, intermediate, and omega types and studied epiglottis histology using pathological autopsy. We measured the power of restitution of epiglottis, by a type classification and by the site classification (upper, middle, and lower point) using the extracted larynx. We studied 349 cases: flat, 167 (48%), intermediate, 126 (36%), and omega, 56 (16%). In histological examination, we recognized ossification of the epiglottic cartilage with aging. For the power of restitution, we recognized a significant difference in all except intermediate and omega of upper point with reference by configuration to each point. We found that the epiglottis had different configuration. In addition, power of restitution of epiglottis was greatly involving the configuration classified in visual, and in particular, power of restitution was big in flat type. Accordingly we thought that indication of diastasis prevention procedure should have been selected by epiglottis configuration.