Safety and Clinical Benefits of Laryngeal Closure in Patients with Amyotrophic Lateral Sclerosis.
Sayaka Yokoi, Naoki Nishio, Takashi Maruo and 11 others
PMID 35507038WHAT IT FOUND
In 26 people with ALS, laryngeal closure had no severe surgical complications. 25 kept swallowing function, and no severe aspiration pneumonia referrals were reported.
This small retrospective series suggests possible benefit, not proof.
Key findings
01Laryngeal closure was performed without grade 3 or 4 complications, and only three of 26 patients had minor grade 1 complications.
02After surgery, 25 patients (96%) maintained swallowing function, and no patients were referred to the hospital for severe aspiration pneumonia.
03Swallowing scores improved significantly after surgery in the spinal-onset ALS group and in patients classified as having no oral intake before surgery.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 26 patients at one institution were reviewed, so rare harms and generalizability are unclear. The study was retrospective and did not include a control group or another surgery for comparison. Patients also had tracheostomy, feeding tubes, ventilation, and antibiotics, so the effect of laryngeal closure alone cannot be separated. Swallowing scores were assessed only about 1 month after surgery. No long-term follow-up results are available for prognosis or eating status after surgery. The authors note that ALS-FRSsw screening did not have adequate diagnostic accuracy in prior work and that videofluoroscopic confirmation is needed. The authors say the results need confirmation in larger multicenter prospective studies.
Declared interests
The Japan Agency for Medical Research and Development funded the work. The text does not report other conflicts or whether the funder designed or wrote the study.
The easy way to misread this
Do not read this as proof that laryngeal closure improves ALS swallowing outcomes. It was a small retrospective review with no control group, short follow-up, and most patients still needed feeding tubes.