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A Novel Surgical Technique for Posterior Glottic Stenosis Using a Silastic Implant

  • Lauren E Melley
    Affiliations
    Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
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  • Ghiath Alnouri
    Affiliations
    Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, and Lankenau Institute for Medical Research, Philadelphia, Pennsylvania
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  • Robert T Sataloff
    Correspondence
    Address correspondence and reprint requests to Robert T Sataloff, Department of Otolaryngology – Head and Neck Surgery, Drexel University College of Medicine, 219 N. Broad Street, 10th Floor, Philadelphia, PA 19107.
    Affiliations
    Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, and Lankenau Institute for Medical Research, Philadelphia, Pennsylvania
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Published:December 23, 2020DOI:https://doi.org/10.1016/j.jvoice.2020.10.022

      Summary

      Objectives

      To introduce a novel surgical technique for the management of posterior glottic stenosis (PGS).

      Methods

      Literature review (PubMed 1973-2020) and case example of a patient treated with novel technique by principal investigator (R.T.S.)

      Results

      Numerous techniques for the treatment of PGS have had varying success. Our patient, a 67-year-old male with a 2-year history of posterior glottic stenosis secondary to multiple, prolonged intubations previously had been treated with several surgical and medical interventions. Three weeks following an additional endotracheal intubation, he presented to our office with PGS recurrence, exhibiting hoarseness, and shortness of breath with any physical activity. He was treated with a silastic sheet placed through a tunnel in the stenosis and sutured posteriorly as a stent. The stent was removed 3 weeks later and the remaining stenosis was divided, successfully treating our patient's PGS with long-term improvement in both respiratory and voice complaints. This led to the design of a stent to be used for this purpose.

      Conclusions

      This new surgical technique addresses a complex clinical problem and provides otolaryngologists with a minimally invasive option for the surgical treatment of PGS that offers advantages over existing techniques. The two-stage procedure should reduce the risk of recurrence, but more experience is needed. This novel implant may be a valuable tool in the treatment of select patients with mild-moderate PGS.

      Key Words

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