title: Endoscopic arytenoid lateropexy for isolated posterior glottic stenosis.
abstract: OBJECTIVE
  A posterior glottic stenosis (PGS) may limit the abduction of the arytenoid cartilages. One option for the treatment of dyspnea in lower grade stenoses is endoscopic laterofixation of the vocal cords after scar excision. In our prospective study, we assess a refined method for effective endoscopic mobilization and lateropexy of the arytenoid cartilages.
  
  
  METHODS
  Thirty-two consecutive patients with PGS underwent surgery. Endoscopically, the scar between the arytenoid cartilages was transected with a CO2 laser. The scars that had spread into the cricoarytenoid joint were transected with a right-angled endolaryngeal scythe designed for this purpose. The lateropexy of the adequately mobilized arytenoid cartilages was performed with a reinforced Lichtenberger's needle carrier instrument, with consideration of the real abduction of the cricoarytenoid joint.
  
  
  RESULTS
  Twenty-eight patients achieved an excellent breathing ability, only effort dyspnea remained in three cases. One patient could not be decannulated due to aspiration. The early postoperative improvement in the airway function test results showed no relationship with the grade of stenoses. However, in cases of higher grade stenoses with bilateral joint damage, the later postoperative airway function results had decreased slightly. In 25 cases, phonation significantly improved after the removal of the fixing sutures.
  
  
  CONCLUSIONS
  After proper mobilization, endoscopic arytenoid lateropexy can be considered as a minimally invasive function-preserving procedure even for severe PGS. This treatment option provides stable improvements in breathing ability and good voice quality without the need for tracheostomy.
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Medical Faculty of the Szeged University, Szeged, Hungary. rovo@invitel.hu
authors.forename: László
authors.initials: L
authors.lastname: Rovó
authors.forename: Kincsõ
authors.initials: K
authors.lastname: Venczel
authors.forename: Attila
authors.initials: A
authors.lastname: Torkos
authors.forename: Valéria
authors.initials: V
authors.lastname: Majoros
authors.forename: Balázs
authors.initials: B
authors.lastname: Sztanó
authors.forename: József
authors.initials: J
authors.lastname: Jóri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001193:Arytenoid Cartilage / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology*; D006801:Humans; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D007829:Laryngostenosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome