title: Acquired Glottic Stenosis-The Ongoing Challenge: A Review of Etiology, Pathogenesis, and Surgical Management.
abstract: OBJECTIVE
  To review the etiology and pathogenesis of acquired glottic stenosis, as well as the workup, patient preparation, interventional options, and their changing trends, as described in the literature since the 19th century until the present day.
  
  
  METHODS
  Literature from the PubMed search engine and the authors' personal experience were used. The search included up to date studies and historical reports covering different aspects of glottic stenosis, such as basic science, pathogenesis, anesthesia, and surgical techniques.
  
  
  RESULTS
  At present, the most common etiology for acquired glottic stenosis is damage to the posterior commissure after intubation. Until less than a century ago, infectious diseases such as diphtheria and syphilis were the most prevalent etiologies. The common pathway of stenosis includes mucosal and cartilaginous ulcers, granulation formation, fibrosis, and tethering scars. Planning of surgical intervention must begin with the matching of expectations with the patient and considering voice versus airway functions. Preoperative tracheotomy should be considered for securing the airway. Anesthesia has to be carefully planned, and both the surgeon and the anesthesiologist have to be familiar with the options for tubeless jet ventilation. Surgical options include a variety of open and endoscopic resection and reconstruction procedures, which are reviewed in this article, followed by images and illustrations based on the authors' experience.
  
  
  CONCLUSIONS
  Acquired glottic stenosis compromises the breathing, voice production, and airway protection. Reconstructing the stenosed glottis is one of the major challenges facing laryngologists in this era. For this reason, the surgeon must be familiar with the variety of treatment options.
authors: Department of Otolaryngology - Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel. Electronic address: Yonatan.lahav@gmail.com.
authors: Yonatan
authors: Y
authors: Lahav
authors: Department of Otolaryngology - Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
authors: Hagit
authors: H
authors: Shoffel-Havakuk
authors: Department of Otolaryngology - Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
authors: Doron
authors: D
authors: Halperin
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D005260:Female; D005931:Glottis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007828:Laryngoscopy / Q000009:adverse effects / Q000295:instrumentation; D007829:Laryngostenosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation; D020127:Recovery of Function; D012307:Risk Factors; D014140:Tracheotomy; D016896:Treatment Outcome
keywords: Dyspnea; Glottis stenosis; Laryngeal reconstruction; Stridor