Gold standard treatment in a patient intractable aspiration with incompetent larynx due to complete laryngeal paralysis is:: (A) Type I Thyroplasty, (B) Tracheostomy, (C) Feeding jejunostomy, (D) Tracheal division & Permanent Tracheostoma
Answer is D. TREATMENT OF COMPLETE LARYNGEAL PALSY: Tracheostomy Gastrostomy Epiglottopexy Vocal cord plication Total laryngectomy Diversion procedures-Laryngotracheal separation, Laryngeal closure& permanent tracheostome Bilateral medialization i.e. Type I thyroplasty for aspiration requires adduction of the entirevocal cord. The technique works in carefully selectedcases of mild aspiration as it does not prevent all aspiration and risks patients requiring a tracheostomy,