A 42-year-old man developed posterior glottic stenosis following an attempt of self-burning. He was intubated for 2 weeks and tracheotomy was performed for a failure of extubation. Laryngoscopy revealed adhesion at the posterior glottis which severely limited abduction of both vocal folds and arytenoids. The scar tissue of the posterior glottis was resected by means of carbon dioxide laser under endolaryngeal microsurgery on two occasions. These two procedure, however, were not successful to stop recurrent stenosis.
An open surgery was conducted. Following laryngofissure, scar tissues were submucously removed. The wound at the posterior glottis was covered by rotation mucosal flaps obtained from the postcricoid area and a free buccal mucosa graft. Human fibrin glue was employed for the grafting. The posterior glottic space was sufficiently enlarged. The tracheostoma was closed 10 months after the surgery. Two years and 6 months after the surgery, the patient has a good respiratory and phonatory function.
On the basis of the successful result in the present case, the authors emphasize the usefulness of free mucosal graft with fibrin glue in the treatment of posterior glottic stenosis. This procedure does not call for the use of a laryngeal stent.
