TITLE:
Endoscopic Management of Severe Supraglottic and Posterior Glottic Stenosis Due to Chemotherapy and Radiation
AUTHORS:
Shaina M. Rubino, Michael J. Pitman
KEYWORDS:
Posterior Glottic Stenosis, Supraglottic Stenosis, Combined Glottic Stenosis, Radiation, Endoscopic Surgery
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.3 No.3,
May
8,
2014
ABSTRACT: Combined posterior and
supraglottic stenosis (CS) often presents as debilitating dysphonia or dyspnea,
secondary to blunt trauma or traumatic intubation. However, CS has proven to be
a late complication of chemoradiation therapy. Traditional treatment of
combined posterior and supraglottic stenosis (CS) secondary to chemoradiation
has been frequently complicated by poor tissue healing. This case study
illustrates a novel endoscopic surgical technique employing a large
laterally-based flap as a posterior glottic keel by rotating it
anteroinferiorly and suturing it in place. As a result of the procedure, the
bilateral vocal folds, which were midline and immobile preoperatively, regained
normal motion. The supraglottic airway was also restored. Successful endoscopic
treatment of CS with bilateral vocal fold immobility is possible using a large
laterally-based flap, even in the face of tissue changes secondary to chemoradiation.