Surgical treatment of persistent dysphagia in stroke patients using a newly reconstructed conduit from the anterior mouth

Dysphagia is common after stroke and may result in malnutrition and aspiration. To prevent the risk of aspiration and to improve the nutritional status, patients with dysphagic stroke have to give up oral intake and become dependent on tube feeding. Restoration of the patients' ability to resume aspiration free oral feeding is important. A 55-year-old male presented following a brainstem stroke and dysphagia. He was treated with a free jejunal flap to divert food from the anterior mouth to the cervical esophagus. Although the flap underwent partial loss, this was reconstructed with a tubed deltopectoral flap, and following a revision procedure for stricture, the patient's diet was advanced to a regular diet. At follow-up, the patient was able to eat by mouth without tube feeding. The application of this diversion technique to treat patients with a medical disease (i.e., stroke) is a step toward resuming oral feedings in this group of patients.