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Laryngeal stenosis definition, types, aetiology, diagnosis & management

Definition of Laryngeal stenosis: 

Cicatricial narrowing of the laryngeal lumen leading to stridor.

Types of Laryngeal stenosis: 

Glottic, supraglottic or subglottic which is the most common
laryngeal-stenosis

Etiology:

Congenital: Failure of canalization of endolarynx before birth.
Acquired:
  • Trauma: Internal laryngeal trauma due to prolonged intubation, laryngeal surgery or radiotherapy to the neck. External trauma with fractured cricoid cartilage.
  • Chronic inflammation: laryngoscleroma, T.B.
  • Tumors: subglottic haemangioma or chondroma, carcinoma (vey rare 1%).

Clinical picture:

  • Mild and moderete cases: no symptoms, or respiratory distress during exertion or upper respiratory infection.
  • Severe cases: biphasic stridor during rest.


Examination:
 by indirect laryngoscopy or flexible larynogscopy to detect the site and degree of
narrowing.
Investigations: to detect the site, length and degree of stenosis.
  • Radiological assessment as plain x-ray and CT scan
  • Direct laryngoscopy under general anaesthesia.
  • Pulmonary function tests pre and postoperative to evaluate prognosis.

Management:

A-Tracheostomy is lifesaving in severe cases.
B-Endoscopic procedure: Laser excision, repeated dilatation
C-External
- Laryngoplasty: Split cricoid, Insert costal cartilage graft & put montgomery tube.
- Resection & end to end anastomosis.

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