Chronic Stenosis of the Larynx with Special Consideration of Skin Grafting

Abstract

1. Treatment for chronic stenosis of the larynx should be delayed until the patient is in the best possible general condition and until any local inflammatory reaction has entirely cleared. 2. The type of treatment indicated in a given instance depends largely on the character and extent of the stenosis rather than on its cause. 3. Bouginage, the most commonly employed procedure in the treatment of stenosis of the larynx, has in our experience at The Mayo Clinic been one of the least effective procedures. 4. Elastic pressure applied by means of soft rubber dilators is one of the most satisfactory methods of treating chronic stenosis. 5. Laryngofissure with excision of the scarring and any thickened or distorted cartilage, followed by skin grafting, is the most effective method of dealing with chronic cicatricial stenosis and often will restore a satisfactory laryngeal lumen after other methods of treatment have failed.

Acquired Glottic Stenosis—The Ongoing Challenge: A Review of Etiology, Pathogenesis, and Surgical Management

“…Less common infectious causes included leprosy, rhinoscleroma, smallpox, measles, pertussis, and blastomycosis. 3 In the later 1900's, trauma became a more prevalent cause, either external or as a result of endotracheal intubation and tracheotomy. Lack (1909) and Jackson (1921) related cricoid damage to urgent tracheotomy performed too high in the trachea.…”

“…If uncontrolled, such diseases might be reactivated or grafted to previously unaffected regions. 3 TREATMENT STRATEGIES, CONSIDERATIONS, AND CONFLICTS Treating the stenosed glottis should be aimed at restoring cricoarytenoid joints mobility, valve mechanisms, breathing, swallowing, and voicing.…”

“…Others suggest that an open procedure is better done as a first resort and not last. 3 Stenting Stenting may prevent restenosis and allow for complete epithelial growth. However, the stent itself may cause irritation, leading to the recurrence of stenosis once the stent is removed.…”

“…The supraglottic approach is the safest and most commonly used.SURGICAL TECHNIQUESBouchut in 1858 and Schrotter in 1870 used laryngostomy tubes to bypass laryngeal stenosis. O'Dwyer in 1885 and later Rogers in 1905 used a preshaped endolaryngeal tube and placed it in the larynx via the mouth, using force when necessary 2,3. Laryngeal dilators were passed through the mouth for anterior glottic web opening, often painful and unsuccessful 5.…”

Temporal Hollowing Augmentation with Titanium Mesh after Autologous Cranioplasty in Temporal Muscle Resected Case: A Case Report

“…6,11,15) As in our case, we could not get firm fixation with HDPE because the hollowing is not due to bony defect but is partial resection of temporalis muscle. The use of dermal fat grafts for restoring facial contour was first reported in 1931 by Figi,5) and its success has been well documented. In general, grafts are harvested from any preexisting abdominal scar in which the tissue is composed of a deep dermis layer and a subdermal fat layer.…”