Abstract
Laryngeal stenosis is a challenging problem for otolaryngologists. Laryngeal trauma and bilateral recurrent nerve palsy were the main causes of laryngeal stenosis in 60 adult cases treated in the Department of Otolaryngology at the University of Tokyo, from 1993 to 2002, although the series also included several cases with unknown causes. Three representative cases are discussed in this paper as well as therapeutic strategies for laryngeal stenosis in adult cases.
For treatment of cicatricial stenosis of the larynx : 1) Framework structures of the larynx should be corrected appropriately, 2) The stenotic area and granulation should be excised, and 3) The raw surface of the mucosa should be covered with an appropriate graft. Options in applying treatment include endoscopic techniques (with or without use of a laser), and open surgical procedures. Among the discussed approaches, a staged procedure by the trough method is very useful for severe cicatricial stenosis of the larynx. For laryngeal stenosis of unknown cause, scar reformation often occurs, and prevention of restenosis is a target of treatment. Some new techniques, such as topical mitomycin application, are also discussed in this paper.
