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Minimally invasive surgery for posterior glottic stenosis
1Department of Otorhinolaryngology, Albert Szent-Györgyi Medical University, Szeged, Hungary.
Summary
This study introduces a minimally invasive endoscopic CO2 laser excision and vocal cord laterofixation to treat posterior glottic stenosis, avoiding tracheostomy. The technique successfully improved airways and vocal cord mobility in most patients, offering a less inconvenient alternative.
Area of Science:
- Otolaryngology
- Laser Surgery
- Airway Management
Background:
- Posterior glottic stenosis often results from prolonged endotracheal intubation.
- Scar tissue formation in the posterior commissure limits vocal cord abduction.
- Current treatments frequently necessitate temporary tracheostomy.
Purpose of the Study:
- To present a minimally invasive endoscopic surgical technique for posterior glottic stenosis.
- To evaluate the efficacy of CO2 laser excision and vocal cord laterofixation.
- To avoid the need for temporary tracheostomy in patients.
Main Methods:
- Endoscopic excision of posterior commissure scar tissue using a CO2 laser.
- Modification of Lichtenberger's endoextralaryngeal vocal cord laterofixation.
- Lateralization of vocal cords until posterior glottic reepithelialization.
Main Results:
- All 5 reported patients achieved satisfactory airways immediately post-procedure.
- Airway patency remained stable, and further scarring was prevented in moderate stenosis cases.
- Vocal cord mobility was recovered when the cricoarytenoid joint was not fixed; partial improvement in severe cases.
Conclusions:
- Minimally invasive endoscopic CO2 laser excision with vocal cord laterofixation is effective for posterior glottic stenosis.
- This technique successfully avoids tracheostomy and restores airway function.
- Patient outcomes depend on the severity of stenosis and cricoarytenoid joint involvement.