gms | German Medical Science

79. 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.

30.04. - 04.05.2008, Bonn

Results of “Lichtenberger Laterofixation” as primary treatment of glottic stenosis

Meeting Abstract

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno20

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Veröffentlicht: 8. Juli 2008

© 2008 Bosch et al.
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The Lichtenberger Laterofixation is a modern technique of treating glottic stenosis, avoiding tracheotomy in many cases. There is a definitive and a temporary subtype. We report results and complications with both modalities in our patients.

Patients and methods: Between 2005 and 2007, 24 patients with bilateral vocal cord paralysis have been treated using the Lichtenberger–technique. A definitive laterofixation was performed in 17 cases, in 7 patients the temporary technique was applied. 2 patients had a tracheotomy before the operation. 12 complete data sets with a sufficient follow up period of more than 12 weeks could be collected. Corticosteroids, broad-spectrum antibiotics and proton pump inhibitors were administered perioperatively. Sutures were removed 21 days after surgery. Subjective quality of voice as well as respiration was documented using german school grades (1=best, 6=worst). Dyspnoea was evaluated using the New York Heart Association (NYHA) scale.

Results: Mean follow-up was 13.9 months. Within this period, a mean NYHA-increase of 1.6 points could be observed (3.6 before vs. 2.0 after surgery). Mean improvement of respiration was 2.3 points (4.5 before vs. 2.2 after surgery). Voice self-assessment decreased by 0.4 points only (2.9 before vs. 3.3 after surgery). Perioperative short-term tracheotomy was required in 1 case. In both patients with tracheostomy prior to laterofixation surgical closure of the stoma became possible.

Conclusion: Laterofixation according to Lichtenberger is a reliable method of treating glottic stenosis of neuogenic origin. While the rate of complications is low, in most cases a satisfying compromise between dyspnoea and dysphonia can be achieved.