Walking but not talking: Laryngeal separation as a novel approach to improve quality of life in bulbar amyotrophic lateral sclerosis

Patients diagnosed with bulbar amyotrophic lateral sclerosis (ALS) inevitably experience acute aspiration due to progressive facial and laryngeal weakness. As they develop complete dysphagia and loss of speech, patients with bulbar ALS often experience a sensation of "drowning" with acute life-threatening airway obstruction during these aspiration events. Here we present a case of utilizing laryngotracheal separation (LTS) as a strategy to eliminate oropharyngeal aspiration with the goal of improving symptom management in a patient with bulbar ALS.

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