WITHDRAWN A Modified Method of Surgical Treatment of Cicatricle Stenosis of the Larynx: A Clinical Case

OBJECTIVES: demotstration of the surgical treatment of recurrent cicatricial laryngeal stenosis.

METHODS: Patient A., aged 42, with recurrent papillomatosis of the larynx, complicated by glottis stenosis of 2 degree. Condition after endolaryngeal removal of papillomatosis. Complaints of significant hoarseness of voice with periodic aphonia, neck muscle tension, apnea. Examination revealed papillomas on the upper surface of the vocal folds on both sides with a diameter of 4-5 mm. Voice Handicap Index scale, an unsatisfactory indicator (78 points) was obtained and was performed operation.

By general intubation anesthesia, the reference laryngoscope is installed and fixed. With the microforceps, a papilloma from the vocal cords was captured and, using a CO₂ laser, it was removed with a 39ms beam with a power of 3.5W. Then the membrane was excised from the place of attachment on the vocal fold on the right to the anterior commissure on one side, creating a pedicle flap on the other side. Adhesions and cicatricial tissue were removed from the side of the flap using microscissors without damaging the bottom layer of the pedicle flap. The formed flap closed the wound surface along the entire length of the left vocal fold and sutures were placed in the area of the anterior commissure, as well as the second suture on the upper border of the flap (6.0 vicryl suture). A suture was placed on the opposite side at the site of the flap excision.

RESULTS: The methods of surgical treatment eleminated stenosis of the larynx and membarne was removed. Voice Handicap Index scale after 1 month showed a good result (44 points).

CONCLUSIONS: The proposed method of surgical treatment for recurrent stenosis of the larynx is relatively simple to perform, less traumatic, effective. The method allows minimizing the rehabilitation period of patients and restore voice quality and respiratory function.