𝔖 Bobbio Scriptorium
✦   LIBER   ✦

Palliative surgery in patients with bulbar amyotrophic lateral sclerosis

✍ Scribed by Steven O. Short; Dr. Allen D. Hillel

Publisher
John Wiley and Sons
Year
1989
Tongue
English
Weight
629 KB
Volume
11
Category
Article
ISSN
1043-3074

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✦ Synopsis

Patients with amyotrophic lateral sclerosis (ALS), a progressive neurodegenerative disorder, commonly develop bulbar symptoms including dysphagia, dysarthria, and defective airway protection. Otolaryngologists/head and neck surgeons are frequently asked to assist in the management of these problems. We reviewed our experience of 13 surgical procedures in 7 patients with advanced bulbar ALS. In spite of technically good surgery, 3 patients died within 1 week of hospitalization. Four patients appeared to benefit from the surgery. Patients with bulbar ALS are a high risk group because of chronic malnutrition and dehydration, covert aspiration and pneumonitis, and diminished ventilation. A team approach to these problems is stressed. Perioperative morbidity can be reduced with careful preoperative preparation and patient selection. HEAD & NECK 11 :364-369,1989 Amyotrophic lateral sclerosis (ALS) is a progressive neurologic disorder characterized by asymmetric muscular weakness, atrophy, and hyperactive reflexes with cramping and spasticity. Sensory pathways and autonomic functions

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