Minimally invasive surgery for posterior glottic stenosis

Posterior glottic stenosis most commonly results from prolonged endotrachea l intubation, The tube causes decubitus and perichondritis with a consequen t scar tissue formation in the posterior commissure that often limits the a bduction of the vocal cords, Many different surgical methods are known for the treatment, but in most cases temporary tracheostomy is required. We rec ommend a minimally invasive method to avoid tracheostomy, which is a very i nconvenient state for the patient. The scar of the posterior commissure is excised endoscopically with the CO2 laser, and a modification of the endoex tralaryngeal vocal cord laterofixation-described by Lichtenberger-is used t o lateralize 1 or both vocal cords until the posterior commissure is comple tely reepithelialized, In this article we report on the first 5 cases. All patients had satisfactory airways immediately after the laterofixation proc edure, which proved to be stable later on as well, In the cases of moderate stenosis, further scarring was prevented, and after the healing of the muc osa in the posterior glottic area, the laterofixation sutures were removed. The vocal cord mobility was recovered in the cases in which the cricoaryte noid joint was not fixed, In 1 case of severe stenosis (bilateral cricoaryt enoid joint fixation), the procedure yielded only partial improvement.