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Suggest Treatment For One-sided Frozen Throat And Swallowing Difficulty After A Stroke

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Posted on Wed, 10 Jun 2015
Question: Hi my son had a stroke 2years ago and hasn't been able to swallow since one side of his throat is frozen is there any operation he could have for him to be able to swallow again he's only 37yrs old
doctor
Answered by Dr. Olsi Taka (25 minutes later)
Brief Answer:
Surgery is performed very rarely

Detailed Answer:
I read your question carefully and I understand the distress you must be in. Disability left from stroke can really affect the life of patients and their family and it is sad that your son has had a severe stroke at such a young age.

I fear that regarding the swallowing problem there is not a lot of advancement apart from the speech therapy he gets. Surgery is often performed for difficulty with swallowing but that usually is when it is related to an obstruction, a mechanical obstacle which can be removed or reduced. Same goes for treatments like botulinum toxin or other medication to reduce esophageal spasm.
In the case of stroke there is no such obstruction, so not much for the surgery to correct.

That being said there are case reports of procedures to by-pass, circumvent the pharynx, using a part of the intestine as a tube to connect the anterior part of the oral cavity directly with the esophagus. It is a question of isolated case reports though, not a common practice, a procedure performed by plastic surgeons usually.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (48 minutes later)
How do I find out more about this product my son XXXXXXX bulbar palsy he was fitted with a cuffed tracheostomy as he is unable to clear his own secretions although they had to remove the tracheotomy before they could discharge him from the hospital. He is constantly spitting into a bowl he will not go out anywhere because people give him hurtful looks because of his spitting they don't understand he has to or it would go in his lungs causing infection
doctor
Answered by Dr. Olsi Taka (37 minutes later)
Brief Answer:
Read below.

Detailed Answer:
Thank you for bringing some more information.

As I said that is not a common procedure and I am afraid I can't advise you as to where you can have it in the UK where you seem to live, you will have to contact a local physician. I am not even sure it is actually performed in the UK as it is not common practice, I found only two isolated reports of patients trying it one in US and one in Taiwan.

Actually to be honest, I mentioned it because you required that information, but personally I would not recommend it. I don't know if you realize what that surgery is about. It involves taking a part of his intestine, his bowel, and use it to connect the mouth to the esophagus (the gullet). I do not know the full technical details as it would require a highly qualified plastic or ENT surgeon, but it is a procedure which entails a risk of complications, like infections, stricture, failed attachment which could be very serious on their own. I don't think it's a risk worth taking even if you found a surgeon willing to go for it.

I can offer an advice on his spitting problem. I wonder if his doctors have considered the use of amitriptyline for that purpose. It is actually an antidepressant which has dry mouth as a side effect. In the case of bulbar palsy though, what is a side effect is actually beneficial and is commonly used in bulbar palsy patients. You can discuss its use with your doctors.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (5 minutes later)
Thank you for your advice I will speak to our doctor about the treatment for his secretions and not go any further with the operation I can't take the risk anything going wrong i couldn't live with that. Thank you x
doctor
Answered by Dr. Olsi Taka (1 minute later)
Brief Answer:
Thank you.

Detailed Answer:
Thank you for using HealthCareMagic. I hope things will work out for the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Treatment For One-sided Frozen Throat And Swallowing Difficulty After A Stroke

Brief Answer: Surgery is performed very rarely Detailed Answer: I read your question carefully and I understand the distress you must be in. Disability left from stroke can really affect the life of patients and their family and it is sad that your son has had a severe stroke at such a young age. I fear that regarding the swallowing problem there is not a lot of advancement apart from the speech therapy he gets. Surgery is often performed for difficulty with swallowing but that usually is when it is related to an obstruction, a mechanical obstacle which can be removed or reduced. Same goes for treatments like botulinum toxin or other medication to reduce esophageal spasm. In the case of stroke there is no such obstruction, so not much for the surgery to correct. That being said there are case reports of procedures to by-pass, circumvent the pharynx, using a part of the intestine as a tube to connect the anterior part of the oral cavity directly with the esophagus. It is a question of isolated case reports though, not a common practice, a procedure performed by plastic surgeons usually. I remain at your disposal for further questions.