For patients with severe posterior laryngeal web and glottic stenosis, we often take an approach involving open surgery (laryngofissure) and free mucosal transplantation. However, when therapies for laryngeal papilloma, leukoplakia, and carcinoma
in situ cause a web and stenosis, open surgery will be undesirable, because of the possibility for the scattering of these diseases. In such cases, all surgical procedures should be performed endolaryngeally. Therefore, we have developed a new surgical approach for the treatment of pesterior laryngeal web and glottic stenosis.
The surgical procedure is as follows.
(1) The web and stenotic regions are removed endolaryngeally.
(2) A little larger stent than the glottic space is inserted and fixed with nylon thread above and below the thyroid cartilage.
(3) Free mucosal flap is placed between the intra-arytenoid region and the stent, fixed only with fibrin glue, endolaryngeally.
(4) 6 weeks later, the stent is removed.
We have seen a patient with severe anterior and posterior laryngeal stenosis. The above procedure was performed for the patient, and the free mucosal flap has been well transplanted and the glottic stenosis improved.
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