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Endoscopic CO2 laser arytenoidectomy for postintubation glottic stenosis
1Department of Otolaryngology-Head and Neck Surgery and General Surgery, West Virginia University Health Sciences Center, Charleston.
Summary
Prolonged endotracheal intubation can cause vocal cord fixation and glottic stenosis. Endoscopic CO2 laser arytenoidectomy successfully restored airway, voice, and swallowing in 10 patients, with added benefits for dysphagia.
Area of Science:
- Otolaryngology
- Laser Surgery
- Respiratory Medicine
Background:
- Prolonged endotracheal intubation can cause cricoarytenoid joint fixation, leading to bilateral midline vocal cord fixation and glottic stenosis.
- This condition necessitates surgical intervention to restore airway patency and vocal function.
Purpose of the Study:
- To evaluate the efficacy of endoscopic CO2 laser arytenoidectomy in treating bilateral midline vocal cord fixation.
- To assess the impact of concomitant cricopharyngeal myotomy on swallowing function in patients with dysphagia.
Main Methods:
- Endoscopic CO2 laser arytenoidectomy was performed on 10 patients with glottic stenosis due to prolonged intubation.
- Eight patients also underwent cricopharyngeal myotomy for severe upper pharyngeal dysphagia.
Main Results:
- All 10 patients experienced a successful return of airway, voice, and swallowing functions.
- The CO2 laser facilitated precise dissection, provided hemostasis, and resulted in minimal scarring during the arytenoidectomy procedure.
Conclusions:
- Endoscopic CO2 laser arytenoidectomy is an effective treatment for glottic stenosis caused by prolonged endotracheal intubation.
- The procedure offers significant advantages, including improved airway, voice, and swallowing, with minimal complications.