Posterior glottic stenosis causing bilateral vocal cord immobility and airway stenosis most frequently occurs after endotracheal intubation. In recent years, there have been an increasing number of reports of posterior glottic stenosis and laryngotracheal stenosis occurring after endotracheal intubation for COVID-19 patients. We encountered a case in which adhesion was released by the cricothyroid ligament approach for posterior glottic stenosis that developed after intubation for COVID-19. Although adhesion could not be noticed on endoscopy, posterior glottic stenosis was suspected based on CT, which demonstrated soft tissue density between the right and left arytenoid cartilage. Adhesion was visible through the tracheotomy hole, leading to the diagnosis of posterior glottic stenosis. Although we attempted transoral surgery using a direct laryngoscope, adhesion could not be visualized. Therefore, we decided to change to the cricothyroid ligament approach. After excising the cricothyroid ligament, the adhesion was accessible and easily released by a CO2 laser under rigid endoscopic inspection. The cricothyroid ligament approach may be useful for posterior glottic stenosis when transoral surgery is difficult.
