Article
Contact laser surgery of paralytic laryngeal stenosis
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Published: | April 19, 2011 |
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During last 15 years in ENT Department of Saint Petersburg I.P.Pavlov Medical University 106 patients underwent laser endoscopic resections of posterior third of vocal fold and vocal process of arytenoid. There were 2 male patients and 104 female. Our previous experience shows that this type of laser resection is the most effective in comparison with chordectomy and arytenoidectomy. In non tracheotomysed patients we performed surgical procedures under general anesthesia with high frequency jet ventilation via tracheopuncture. Pre- and postoperative patients were examined with indirect- and fibrolaryngoscopy, measurement of rima glottidis and respiratory function assessment was performed. Total number of partial laser chordarytenoidectomies was 117. Among them 81 operations made on the left side and 36 operations made on the right side. Unilateral resection was an adequate one for respiratory function rehabilitation in 95 patients. Bilateral resection was performed in 11 patients. Laser beam produces a low inflammation after resection. So, no one patient was tracheotomised in postoperative period. 43 patients of the total number of patients were tracheotomised before their hospitalization to our Clinic. Some of them had a combination of bilateral vocal cord paralysis and the granulations to be founded at cannula level. Complications were observed in 6 cases: 5 interarytenoid scar bridges, 1 postoperative bleeding. Bleeding was stopped by catheter with cuff. Scar bridges were reoperated successfully. All cannula patients were decannulated.