gms | German Medical Science

76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

04.05. - 08.05.2005, Erfurt

Endoscopic treatment of posterior commissure stenosis

Meeting Abstract

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  • corresponding author László Rovó - Department of Otorhinolaryngology, University of Szeged, Hungary
  • author György Smehák - Department of Otorhinolaryngology, University of Szeged, Hungary
  • author Jenő Czigber - Department of Otorhinolaryngology, University of Szeged, Hungary
  • author József Jóri - Department of Otorhinolaryngology, University of Szeged, Hungary

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno289

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2005/05hno244.shtml

Veröffentlicht: 22. September 2005

© 2005 Rovó et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: In severe cases of posterior glottic stenosis, when both cricoarytenoid joints (CAI) are destroyed and fixed by scar tissue, often only the external surgical interventions have been proven to be successful. These procedures require tracheostomy. The aim of this study is to introduce a minimally invasive endoscopic method.

Material & Methods: The results of 13 patients with a minimum of one year follow-up period (mean age:.43 years, SD ± 18 years) were examined. In 9 cases the structure of the CAI intraoperatively proved to be intact at least on one side. (A), with in the other 9 patients (B) both CAI structures were involved by the scar. In group A, the arytenoid cartilages were fixed temporarily in the physiological abducted position by one, endoscopically inserted suture (Prolene 1-0) for 6 weeks after the transsection of the posterior glottic scar by CO2 laser. In group B, the scar resections were extended with intracapsular scar transsection by a special blade, designed for this intervention by the authors. After this arytenoid cartilages were fixed definitively by the way mentioned above. Pre – (1), early postoperative (II) and late postoperative (III) (12th month) peak inspiratory flow (PIF) values were meastured.

Results: A: avg. PIF I:0,84 L/s, avg.PIF II:2,15 L/s, avg.PIF III: 2 L/s. The recovery of vocal cord function was supported by objevtive voice analysis in A, and the voice remained hoarse but socially acceptable in B.

Discussion: this minimally invasive method provides immediate and stable significant increase in breathing even int he difficult cases of posterior glotticstenosis without tracheotomy. Moreover, it can be a reversible method from the phonation’s point of view.


References

1.
Rovó L, Jóri J, Brzózka M, Czigner J. Minimally invasive surgery for posterior glottic stenosis. Otolaryngology-Head and Neck Surgery. 1999;121:153-6.
2.
Rovó L, Jóri J, Brzózka M, Czigner J. Airway complication after thyroid surgery: Minimally invasive management of bilateralrecurrent nerve injury. Laryngoscope. 2000;110:140-4.