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Dr J Burk
Dr J Burk, Doctor (MD)
Category: Health
Satisfied Customers: 2639
Experience:  MBBS MRCGP
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Is there any surgery anywhere that can correct an ...

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Is there any surgery anywhere that can correct an epiglottis that does not open and close properly. I heard of a surgery for "floppy epiglottis". I don''t know if that is similar to what my dad might need to have done. He probably had a mini stroke a few years ago that caused this situation. He also has a tongue retraction and larynyx problem, those two situations being strengthened by a speech therapist. He has had aspiration pneumonia many times in the last 3-4 years, and now we know the probable cause. Any suggestions would be greatly appreciated.

Are you referring to his uvula ( the dangly bit at the back of the mouth) or his actual epiglottis that covers the entrance to the airway when we swallow?

Dr Jef
Customer: replied 9 years ago.
The speech therapist said the actual epiglottis...she said it was cartilage and that no exercises to improve and strengthen muscles as she will try to improve in the tongue retraction and larynx issues.


If it is his epiglottis then there are absolutely no surgical options.

Surgery would only make things worse.


Dr Jef

Was wondering if anyone has offered you the option of a percutaneous feeding tube - a PEG - this is a feeding tube that is placed in the minor operating room through the skin into the stomach. Just a little nick with a knife blade and an endoscope are used. This can be done with sedation not anesthesia and some local anesthetic if necessary.
Although this will not allow the epiglottis to heal in any way, it will allow your Dad to receive all the nutrition and medications that he needs without the risk of aspirating and developing pneumonia again.

You can see a pic and a brief description at this site.

Customer: replied 9 years ago.
Thank you for your reply. I neglected to tell you that my dad was in the Intensive Care Unit (aspiration pneumonia) for 40 days between Feb. 11 and April. After having been put on a respirator on Feb. 18, he had a peg tube and tracheostomy a few days later. He's now in a nursing home for rehabilitation....the trach was removed on April 18 when he got out of the hospital. He still is on continuous feeding with the peg tube.

It appears the peg tube will have to be permanent. The only eating the speech therapist says he might be able to do will be "pleasure eating", maybe small amounts of ice cream, etc. eaten with a regiment of swallowing, throat clearing and coughing after each bite. I'm sure he will not be risk free for aspiration even if he eats by the "technique" as trained. Sounds like he will be continuing to have bouts of pneumonia if he eats at all. She says we would have to watch for fever and get him on antibiotics. He should have another barium swallow test in about 3 weeks.

Another question: Could the epiglottis problem have been caused by anything other than a stroke? or mini-stroke?
Do you haved any suggestions?

Hi - there are other neurological problems that can affect the swallowing reflex but if he has had a stroke then that will be the reason.

I'm sorry to say but speech therapy and monitoring any improvement with barium exams is the only recognized treatment.

He will always be at risk of aspiration unless there is a very significant improvement.

Dr Jef
Dr J Burk, Doctor (MD)
Category: Health
Satisfied Customers: 2639
Experience: MBBS MRCGP
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