A novel surgical treatment for posterior glottic stenosis using thyroid ala cartilage – A case report and literature review

Gaffey, Megan M.; Sun, Ravi W.; Richter, Gresham T.

doi:10.1016/j.ijporl.2018.07.025

Cited by 6 publications

(9 citation statements)

References 8 publications

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“…They present with a unilateral, adducted, and immobile vocal fold due to the fixated side and a contralateral hypomobile vocal fold. 1,3 In the most severe form or class IV, the CAJs are fixed bilaterally. 1,3 Tracheostomy is often temporarily necessary for severe PGS to maintain airway patency.…”

Section: Discussionmentioning

confidence: 99%

“…1,3 Reduced arytenoid mobility and a posterior commissure scar characterize class II PGS. 1,3 Class III patients have unilateral CAJ fixation. They present with a unilateral, adducted, and immobile vocal fold due to the fixated side and a contralateral hypomobile vocal fold.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Without treatment, PGS can lead to total laryngeal obstruction and respiratory failure. 3 Here, we present a case of rapid acute bilateral CAJ fixation following 2 days of intubation for cardiac surgery. This case is of particular interest for anesthesiologists and intensivists who may encounter this as an etiology of respiratory distress and critical airway obstruction.…”

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confidence: 99%

“…2 Acquired PGS generally presents 4 to 8 weeks after extubation. [3][4][5][6] Symptoms include progressive dysphonia, dyspnea, and stridor as ongoing joint fibrosis reduces normal vocal fold motion. 2,3 Without treatment, PGS can lead to total laryngeal obstruction and respiratory failure.…”

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Acute Cricoarytenoid Joint Fixation Following Routine Intubation: A Case Report

et al. 2023

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Prolonged intubation is a common cause of injury to the posterior larynx often resulting in cricoarytenoid joint (CAJ) fixation and posterior glottic stenosis (PGS). We present a case of respiratory failure due to acute bilateral CAJ fixation and PGS following only 2 days of intubation for routine cardiac surgery. A tracheostomy was placed due to critical airway obstruction. Clinicians should remain vigilant for laryngeal injury presenting as CAJ fixation and PGS. Prompt surgical consultation is advised as early intervention is associated with reduced morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Acute Cricoarytenoid Joint Fixation Following Routine Intubation: A Case Report

et al. 2023

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“…Especially for PGS grade II, TOLMS is a valuable option in combination with PMAF [1,4]. On the other hand, for more severe PGS (Grades III and IV) a number of authors strongly recommend airway expansion, especially if associated with subglottic stenosis [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Functional outcomes after transoral CO2 laser treatment for posterior glottic stenosis: a bicentric case series

Filauro

Missale

Vallin

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose The aim of this study is to evaluate functional outcomes in terms of decannulation rate and quality of life of patients affected by PGS (Grades I–IV) treated only by transoral CO2 laser microsurgery (TOLMS) in two tertiary centers. Methods An observational retrospective study was carried out, enrolling 22 patients affected by PGS who were treated by a transoral approach at two tertiary referral centers. Surgical treatment included TOLMS with tailored laser resection of the scar tissue combined with posterior cordotomy, resurfacing of the raw area with mucosal microflap, or placement of a Montgomery T-tube or Keel stent. All patients were evaluated and staged preoperatively and postoperatively, at least 6 months after the surgery. Functional outcomes were objectively evaluated by the Airway-Dysphonia-Voice-Swallowing (ADVS) staging system, Voice Handicap Index-30 (VHI-30), and Eating Assessment Tool-10 (EAT-10) questionnaires. Results Quality of life significantly improved as measured by the VHI-30 questionnaire with a median variation of − 31.0 (p = 0.003), the EAT-10 with a median variation of − 4.0 (p = 0.042), and the ADVS with a median variation of − 3.5 (p < 0.001). No significant changes were observed in swallowing scores. We were able to decannulate 7 of 9 patients (almost 80%) with previous tracheotomy. Conclusion In conclusion, even if there is still no general agreement on an exact therapeutic algorithm to treat PGS, our results confirm that transoral surgery, in terms of scar tissue removal, combined in selected patients with posterior cordotomy and pedicled local flaps and/or placement of stents, represents a safe and effective surgical approach even for more severe PGS.

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Swellings of the Laryngeal/Pharyngeal Region

Sakr

2024

Midline Neck Swellings

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A novel surgical treatment for posterior glottic stenosis using thyroid ala cartilage – A case report and literature review

Cited by 6 publications

References 8 publications

Acute Cricoarytenoid Joint Fixation Following Routine Intubation: A Case Report

Acute Cricoarytenoid Joint Fixation Following Routine Intubation: A Case Report

Functional outcomes after transoral CO2 laser treatment for posterior glottic stenosis: a bicentric case series

Swellings of the Laryngeal/Pharyngeal Region

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