title: Endoscopic treatment of glottic stenosis: a report on the safety and efficacy of CO2 laser.
abstract: BACKGROUND
  Treatment of glottic stenosis is a considerable challenge to the otolaryngologist. Glottic airway patency can be compromised by bilateral vocal fold palsy, anterior webbing or a posterior segment scar, which may be significant enough to impair arytenoid movement.
  
  
  METHODS
  A retrospective analysis of a prospective database of patients (n = 34) treated by a specialist airway surgeon. All patients underwent endoscopic treatment with a CO(2) laser in an attempt to improve airway calibre and, in 12 patients, to decannulate tracheostomy tubes.
  
  
  RESULTS
  Twenty-one patients had bilateral vocal fold palsy and 13 had predominantly posterior glottic stenosis. A variety of pathology-directed treatment approaches were used to achieve good functional results. Four patients required a second endoscopic procedure. The overall revision rate was 5 per cent for bilateral fold palsy and 23 per cent for posterior glottic stenosis (p < 0.05). All patients had an adequate functional airway calibre, and all 12 tracheotomised patients were decannulated.
  
  
  CONCLUSIONS
  Pathology-directed endoscopic laser surgery is safe and effective treatment for glottic stenosis. Rather prescriptive use of unilateral or bilateral cordotomy or combined cordo-arytenoidectomy, clinicians must perform the procedure that will treat the lesion most adequately. Our success rate compared favourably with the best reported results.
authors: Department of Otolaryngology, Head and Neck Surgery, Royal North Shore Hospital and Westmead Hospital, Sydney, New South Wales, Australia. friffat@gmail.com
authors: F
authors: F
authors: Riffat
authors: C E
authors: CE
authors: Palme
authors: D
authors: D
authors: Veivers
mesh_terms: D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D001193:Arytenoid Cartilage / Q000601:surgery; D005260:Female; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000209:etiology / Q000601:surgery*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D011788:Quality of Life; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014139:Tracheostomy / Q000009:adverse effects; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000150:complications / Q000601:surgery*