Microtrapdoor Flap Technique for Treatment of Glottic Laryngeal Stenosis: Experience With 34 Cases.
OBJECTIVE
Laryngeal stenosis is the most challenging disorder for the laryngologist to treat. Microtrapdoor flap technique was described in 1980s; however, it has not been popular since then. The reason may be the difficulty of the technique. In this study, we will report our experience with microtrapdoor flap technique to treat glottic stenosis of 34 patients.


METHODS
Retrospective case series of a tertiary referral center.


METHODS
Twelve male and 22 female patients make up our study group. All patients, but one, had pure glottic stenosis. The other patient had combined supraglottic and glottic stenosis. Unilateral or bilateral microtrapdoor technique was applied to all patients. The patients are required to have at least 1 year postoperative follow-up.


RESULTS
The etiology of glottic stenosis includes 19 cases due to failed surgery for bilateral vocal fold paralysis; seven cases due to microlaryngoscopy (three laryngeal papilloma, one leukoplakia excision, one glottic cancer excision, one foreign body extraction, one biopsy from interarytenoid region); four cases due to prolonged intubation; one case due to laryngeal fracture, one case due to vertical laryngectomy, one case due to smoke inhalation (burn), and one case congenital or idiopathic. Seventeen patients had tracheotomy. All seventeen of them were decannulated 2 months postoperatively. Thirty-three patients (97%) were dyspnea free on exertion 1 year postoperatively. One patient developed restenosis and dyspnea 1 year after treatment; she needs retreatment.


CONCLUSIONS
Microtrapdoor flap technique is a successful surgical option for treatment of short-segment laryngeal stenosis.
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey. Electronic address: tyilmaz@hacettepe.edu.tr.
Taner
T
Yılmaz
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Nilda
N
Süslü
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Rıza Önder
RÖ
Günaydın
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Oğuz
O
Kuşçu
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Tevfik
T
Sözen
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Gamze
G
Atay
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Münir Demir
MD
Bajin
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000009:adverse effects / Q000379:methods*; D007829:Laryngostenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
Airway obstruction; Laryngoscopy; Laryngostenosis; Larynx; Tracheotomy