Indications for internal closure of the larynx are the same as those set out by Smith, Spalding, Ardran, and Livingstone (1965) for laryngectomy in non-malignant conditions. There should be no prospect of recovery from the pharyngeal palsy which endangers the life of the patient from inhalation pneumonia. The advantage of closure of the larynx over laryngectomy is that it is only a mildly traumatic procedure, being less disturbing generally and likely to avoid complications at the operation site. This simple procedure could play an important part in hastening the rehabilitation of patients with permanent pharyngeal dysphagia, allowing early removal of the tracheotomy tube. Rather than adding to the difficulties in swallowing, as a laryngectomy may do, simple closure of the larynx can increase the patient's confidence in swallowing, with early resumption of normal feeding.
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