Tracheoesophageal Diversion and Laryngotracheal Separation

Lindeman described tracheoesophageal diversion in 1975. This procedure for chronic aspiration was devised with the objective of developing a reliable surgical technique that would control aspiration for an indefinite period while preserving the larynx and the integrity of the recurrent laryngeal nerves. The procedure was designed to be reversible if healthy laryngeal protective function returned.
Tracheoesophageal diversion is performed by horizontal division of the trachea at the fourth and fifth tracheal rings. The proximal tracheal segment is anastomosed in an end-to-side fashion to an opening in the anterior esophagus. The distal tracheal segment is used to create a tracheostoma.



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