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Posterior glottic fixation in children

G H Zalzal1

  • 1Department of Otolaryngology, Children's National Medical Center, George Washington University, Washington, DC 20010.

The Annals of Otology, Rhinology, and Laryngology
|September 1, 1993
PubMed
Summary

Posterior glottic stenosis in children can cause airway obstruction. Scar incision with cricoid split, cartilage grafting, and stenting effectively treats vocal cord fixation, restoring airway and voice function.

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Laryngology

Background:

  • Posterior glottic stenosis can lead to progressive airway obstruction in children.
  • Vocal cord fixation, often secondary to stenosis, impairs vocal cord mobility and can necessitate tracheotomy.

Purpose of the Study:

  • To evaluate the efficacy of scar incision with posterior cricoid split, cartilage grafting, and stenting for treating posterior glottic stenosis with vocal cord fixation in pediatric patients.
  • To assess decannulation rates, vocal cord mobility, voice quality, and aspiration post-treatment.

Main Methods:

  • A retrospective study of 25 tracheotomy-dependent children with posterior glottic stenosis and impaired vocal cord mobility.
  • Surgical intervention included scar incision, posterior cricoid split, stenting, and cartilage grafting in 11 patients.
  • Postoperative assessment of airway patency, vocal cord function, and voice quality.

Main Results:

  • All 25 children were successfully decannulated after the procedure.
  • Ten patients regained full vocal cord mobility; one had limited adduction, and two experienced recurrent fixation.
  • Good voice results were achieved with no instances of aspiration.

Conclusions:

  • Scar incision combined with posterior cricoid split, cartilage grafting, and stenting is a highly effective treatment for posterior glottic fixation in children.
  • This surgical approach successfully restores airway patency and vocal cord mobility while preserving healthy laryngeal tissue.
  • The technique offers excellent functional outcomes, including good voice quality and prevention of aspiration.

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