Experience of contact laser surgery in paralytic laryngeal stenosis

Bilateral laryngeal paralysis is associated with an increased mortality and impairment in the quality of life. The primary treatment goal for all types of paralytic stenosis is to restore adequate breathing. The first surgical step for adult patients with paralytic stenosis is endoscopic laryngeal interventions to restore the airway lumen. The first surgery should be performed within 6 months after the onset of paralytic stenosis, as it is known that it is possible to restore mobility of one of the vocal cords during this period. Once the endoscopic methods are ineffective, the next step involves external surgery for paralytic laryngeal stenosis. Cordotomy with partial arytenoidectomy is one of the possible surgical treatments for bilateral paralysis of larynx. The development of laser technologies made it possible to perform endoscopic cordotomy with partial arytenoidectomy without preventive tracheostomy. At the Department of Otorhinolaryngology with Clinic of Pavlov First Saint Petersburg State Medical University, the method of choice in the treatment of paralytic stenosis is laser endoscopic cordotomy with partial arytenoidectomy using mainly semiconductor lasers with wavelengths of 1940, 980, and 445 nm. The article presents a retrospective analysis of the results of surgical interventions for bilateral laryngeal paralysis. Laser endoscopic cordotomy with partial arytenoidectomy with and without preventive tracheostomy has shown its clinical efficacy. In the study group, all the previously tracheotomized patients were decannulated in the postoperative period.

Key words: paralytic stenosis, laryngeal paralysis, laryngeal stenosis, endolaryngeal interventions, cordotomy
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study