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Severe subglottid stenosis, well-tolerated for many years
S Mariotta1, L Guidi, E Li Bianchi
1Università La Sapienza, Dip Scienze Cardiovascolari e Respiratorie, Rome, Italy.
Summary
A man experienced breathing difficulties due to a narrowed subglottic area, a complication from childhood intubation. CO2 laser therapy successfully widened the airway, improving his exertional dyspnea.
Area of Science:
- Otolaryngology
- Pulmonology
- Laser Surgery
Background:
- A 45-year-old male presented with dyspnea.
- History of orotracheal intubation at 1 year old for croup diphtheria, leading to dysphonia.
- Onset of exertional dyspnea at age 39, with prior ineffective aerosol therapy.
Observation:
- Flow-volume loop showed impairment at high flows, including reduced peak expiratory flow (PEF) and maximum expiratory flow at 75% (MEF75%).
- Fiberoptic bronchoscopy revealed a thin, smooth diaphragm with a small (7-8 mm) central subglottic orifice.
Findings:
- The patient's symptoms were attributed to a subglottic stenosis.
- CO2 laser therapy was performed to address the airway obstruction.
Implications:
- Laser therapy successfully increased the cross-sectional area of the subglottic diaphragm orifice.
- This intervention led to symptomatic improvement in the patient's dyspnea.
- Highlights CO2 laser therapy as an effective treatment for subglottic stenosis secondary to intubation.