The glottis is not round: Teardrop‐shaped glottic dilation for early posterior glottic stenosis. (27th December 2018)
- Record Type:
- Journal Article
- Title:
- The glottis is not round: Teardrop‐shaped glottic dilation for early posterior glottic stenosis. (27th December 2018)
- Main Title:
- The glottis is not round: Teardrop‐shaped glottic dilation for early posterior glottic stenosis
- Authors:
- Rosen, Clark A.
Wang, Hailun
Cates, Daniel J.
Smith, Libby J. - Abstract:
- Abstract : Objectives: Posterior glottic stenosis (PGS) results in severe derangement of laryngeal configuration and function with significant morbidity as a sequalae. Presently, there is no treatment for patients with "early" PGS. Dilation is often used for stenotic disease, but present dilation methods are limited to a round shape and the glottis is a sector (teardrop‐shaped). Round dilation of the larynx results in compression of the membranous vocal folds (with potential for injury) and minimal expansion of the posterior larynx. We present a novel laryngeal dilation method that matches the unique anatomic shape of the glottis: teardrop‐shaped glottis dilation (TSGD). Methods: We present a clinical series of early PGS patients treated with a TSGD. Five patients with dyspnea and significantly reduced vocal fold mobility due to early PGS were treated with TSGD, which involves placement of a triangular static stent in the anterior glottis, with simultaneous use of a round balloon dilator in the posterior glottis. Results: All patients reported improved ease of breathing and decrease in Dyspnea Index score and were decannualated following treatment. Video perceptual analysis of pre‐/postlaryngoscopy examinations was performed with five blinded reviewers, and all patients were scored to have improved posterior glottic airway space following treatment with a mean improvement of 2.4 on a 11‐point scale. Conclusion: These clinical results demonstrate that there is enormousAbstract : Objectives: Posterior glottic stenosis (PGS) results in severe derangement of laryngeal configuration and function with significant morbidity as a sequalae. Presently, there is no treatment for patients with "early" PGS. Dilation is often used for stenotic disease, but present dilation methods are limited to a round shape and the glottis is a sector (teardrop‐shaped). Round dilation of the larynx results in compression of the membranous vocal folds (with potential for injury) and minimal expansion of the posterior larynx. We present a novel laryngeal dilation method that matches the unique anatomic shape of the glottis: teardrop‐shaped glottis dilation (TSGD). Methods: We present a clinical series of early PGS patients treated with a TSGD. Five patients with dyspnea and significantly reduced vocal fold mobility due to early PGS were treated with TSGD, which involves placement of a triangular static stent in the anterior glottis, with simultaneous use of a round balloon dilator in the posterior glottis. Results: All patients reported improved ease of breathing and decrease in Dyspnea Index score and were decannualated following treatment. Video perceptual analysis of pre‐/postlaryngoscopy examinations was performed with five blinded reviewers, and all patients were scored to have improved posterior glottic airway space following treatment with a mean improvement of 2.4 on a 11‐point scale. Conclusion: These clinical results demonstrate that there is enormous potential for the identification and treatment of patients with early PGS and use of a laryngeal dilation technique that matches the anatomic configuration of the glottis. Level of Evidence: 4 Laryngoscope, 129:1428–1432, 2019 … (more)
- Is Part Of:
- Laryngoscope. Volume 129:Number 6(2019)
- Journal:
- Laryngoscope
- Issue:
- Volume 129:Number 6(2019)
- Issue Display:
- Volume 129, Issue 6 (2019)
- Year:
- 2019
- Volume:
- 129
- Issue:
- 6
- Issue Sort Value:
- 2019-0129-0006-0000
- Page Start:
- 1428
- Page End:
- 1432
- Publication Date:
- 2018-12-27
- Subjects:
- Posterior glottic stenosis -- PGS -- bilateral vocal fold immobility -- laryngeal dilation -- balloon dilation -- dyspnea -- laryngeal stenosis
Otolaryngology -- Periodicals
617.51005 - Journal URLs:
- http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1531-4995/issues ↗
http://www.interscience.wiley.com/jpages/0023-852X ↗
http://www.laryngoscope.com ↗
http://onlinelibrary.wiley.com/ ↗ - DOI:
- 10.1002/lary.27594 ↗
- Languages:
- English
- ISSNs:
- 0023-852X
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 5156.200000
British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 10399.xml