Douglas D Leventhal1, Elizabeth Krebs, Marc R Rosen. 1. Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
Abstract
OBJECTIVE: To describe our technique and experience of treating adult subglottic stenosis using the Nd:YAG laser through a flexible bronchoscope via a fiberoptic delivery system. DESIGN: Retrospective chart review. PATIENTS: This study included 16 patients with subglottic stenosis who presented to the senior surgeon (M.R.R.) for laser bronchoscopy from January 2000 to December 2006. MAIN OUTCOME MEASURES: Progression toward decannulation and preoperative and postoperative symptoms were assessed. RESULTS: Four of 7 patients who required tracheostomy tubes at the start of laser bronchoscopy underwent decannulation. None of the remaining 9 patients required tracheostomy tubes during treatment. All patients had improvement in their symptoms. Complications of the procedure were minimal. CONCLUSIONS: Bronchoscopy with the Nd:YAG laser is a well-tolerated and effective treatment for subglottic stenosis. Laryngotracheal trauma caused by an endotracheal tube and/or rigid bronchoscope is avoided. This procedure may be useful to achieve and maintain a patent airway.
OBJECTIVE: To describe our technique and experience of treating adult subglottic stenosis using the Nd:YAG laser through a flexible bronchoscope via a fiberoptic delivery system. DESIGN: Retrospective chart review. PATIENTS: This study included 16 patients with subglottic stenosis who presented to the senior surgeon (M.R.R.) for laser bronchoscopy from January 2000 to December 2006. MAIN OUTCOME MEASURES: Progression toward decannulation and preoperative and postoperative symptoms were assessed. RESULTS: Four of 7 patients who required tracheostomy tubes at the start of laser bronchoscopy underwent decannulation. None of the remaining 9 patients required tracheostomy tubes during treatment. All patients had improvement in their symptoms. Complications of the procedure were minimal. CONCLUSIONS: Bronchoscopy with the Nd:YAG laser is a well-tolerated and effective treatment for subglottic stenosis. Laryngotracheal trauma caused by an endotracheal tube and/or rigid bronchoscope is avoided. This procedure may be useful to achieve and maintain a patent airway.
Authors: Deep B Gandhi; Andrew Rice; Chamindu C Gunatilaka; Nara S Higano; Robert J Fleck; Alessandro de Alarcon; Catherine K Hart; I-Chun Kuo; Raouf S Amin; Jason C Woods; Erik B Hysinger; Alister J Bates Journal: Laryngoscope Date: 2021-01-05 Impact factor: 2.970