Subglottic Mucosal Flap: Endoscopic Single‐Stage Reconstruction for Anterior Glottic Stenosis
| Autor: | Meir Warman, Yonatan Lahav, Yael Shapira-Galitz, Doron Halperin, Hagit Shoffel-Havakuk, Oded Cohen |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Natural Orifice Endoscopic Surgery Glottis medicine.medical_specialty Anterior commissure Papillomatosis Free Tissue Flaps Restenosis Carcinoma medicine Humans Aged Retrospective Studies Aged 80 and over business.industry Laryngostenosis Middle Aged Plastic Surgery Procedures medicine.disease Surgery Stenosis medicine.anatomical_structure Otorhinolaryngology Dysplasia Vocal folds Female medicine.symptom business Airway |
| Zdroj: | The Laryngoscope. 132:612-618 |
| ISSN: | 1531-4995 0023-852X |
| Popis: | OBJECTIVES/HYPOTHESIS Anterior glottic stenosis (AGS) results from surgical intervention, carcinoma, papillomatosis, congenital, or idiopathic causes. It may be present as elastic web or fibrotic scar. It impairs vocal function and glottic airway. Reconstructive options include resection and placement of a keel or glottic web-based mucosal flaps to prevent restenosis. These methods may not be sufficient for reconstructing a thick anterior scar and may require multiple interventions. The aim of the study was to describe the anterior subglottic mucosal flap (ASGMF), a one-stage, keel-free technique for AGS repair. STUDY DESIGN A retrospective cohort. METHODS Patients with AGS were operated using the ASGMF between 2017 and 2020. The stenotic segment was excised, and then an ASGMF was developed. A unilateral oblique incision was performed to allow rotation and advancement of the flap toward the contralateral vocal fold. The flap was sutured to the mucosal edge of the vocal fold to create mucosal continuity and prevent restenosis. Vocal fold length ratio (VFLR), which is between the free part and the total vocal fold length, as well as stroboscopic measures, were calculated before and after surgery. RESULTS Twelve patients were enrolled. Etiologies were iatrogenic, dysplasia, papillomatosis, carcinoma, and congenital. Average VFLR improved from 0.33 to 0.87 (P-value |
| Databáze: | OpenAIRE |
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