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Endoscopic surgical treatment of posterior glottic stenosis

Published online by Cambridge University Press:  22 May 2009

S Chitose ,
H Umeno  and
T Nakashima
S Chitose*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
H Umeno
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
T Nakashima
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
*
Address for correspondence: Dr Shunichi Chitose, Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. Fax: +81 942 37 1200 E-mail: [email protected]
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Abstract

A six-year-old girl developed posterior glottic stenosis following surgery for lateral curvature. She was post-operatively intubated for 17 days and had inspiratory stridor after extubation. Laryngoscopy revealed an adhesion at the posterior commissure which severely limited abduction of the bilateral vocal folds and arytenoids. Initially, tracheal fenestration was performed and the scar tissue of the posterior commissure was vaporised using a CO2 laser under endolaryngeal microsurgery. However, despite this procedure the stenosis reformed and an interarytenoid adhesion developed.

Endolaryngeal microsurgery was performed again three months later. Using endoscopic microscissors, the posterior commissure and interarytenoid scar tissue were submucosally separated and the bilateral corniculate cartilages of the superior arytenoids were debulked using CO2 laser. A posteriorly based mucosal flap obtained from the postcricoid region was extended to approximate to the mucosa of the posterior commissure. The mucosal flap was sutured to the inferior subglottic mucosa by two 4–0 polyglactin absorbable sutures. Three months later, the patient's respiratory and phonatory function was satisfactory.

Based on the successful results of the present case, the authors highly recommend the use of a posterior mucosal flap for the treatment of posterior glottic stenosis. This procedure does not require the use of either a laryngofissure or a laryngeal stent.

Keywords

Posterior Glottic StenosisPosterior CommissureInspiratory StridorPosterior Mucosal Flap
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Supplement S31 , May 2009 , pp. 68 - 71
Copyright
Copyright © JLO (1984) Limited 2009

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