Posterior glottic stenosis
by Philippe Monnier T, Philippe Vicky S, Philippe Bachi T

Jaypee’s Video Atlas of Operative Otorhinolaryngology AND Head & Neck Surgery

by Vicky S Khattar, Bachi T Hathiram
About Video

This video demonstrates one of the surgical techniques for the treatment of posterior glottic stenosis. This is one of the most challenging conditions to manage. It can be treated by endolaryngeal as well as ‘open’ techniques. In this case, there is a web present in the posterior glottis, keeping both the vocal folds adducted, and preventing abduction. The vocal fold mobility is intact, which has already been confirmed by a laryngoscopy. A CO2 LASER is used to vaporize the posterior glottic web followed by gentle dilatation using gum-elastic bougies. The LASER cuts are made along an imaginary line extrapolated along the free edge of the vocal folds. A laryngeal stent is then placed endoscopically and secured in place using Prolene sutures. The use of a Litchenberger needle carrier is invaluable for fixing the endolaryngeal stent, and has been demonstrated here. The stent is usually kept for a period of 6 to 12 weeks, following which it is removed. The stent used here is the Easy LT Mold® that has been devised by Professor Philippe Monnier from Switzerland, and helps maintain the vocal folds in an abducted position, so as to allow for mucosalization along a wide posterior glottis.

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