2023 Volume 126 Issue 10 Pages 1142-1147
Posterior glottic stenosis (PGS) is caused by trauma or inflammation, such as occurs in endotracheal intubation. Although curable, PGS is often misdiagnosed as bilateral vocal fold paralysis and left without surgical interventions. In this report, we discuss two cases of PGS.
Patient 1 is a 44-year-old woman who had an endoscopic finding of a bridging scar between the vocal processes, leading to the diagnosis of Bogdasarian classification Type I (vocal process adhesion) PGS. We separated the adhesions under the guidance of a direct laryngoscope. Patient 2 is a 61-year-old man who was diagnosed with bilateral vocal fold paralysis and underwent tracheotomy. Although no adhesive lesion could be found by conventional endoscopic observation from the oral side, observation through the tracheal stoma showed a bridging scar between the posterior commissure. Additionally, a scar was found at the right cricoarytenoid joint, leading to the diagnosis of PGS Type III (posterior commissure stenosis with unilateral cricoarytenoid ankylosis). Since we struggled to obtain sufficient surgical views through the oral approach, we severed the adhesion using a CO2 laser through the tracheal stoma under the guidance of a rigid endoscope. The choice of an adequate surgical approach is important for the treatment of PGS according to adhesion type.
