ĐIỀU TRỊ DÍNH MÉP TRƯỚC DÂY THANH BẰNG PHƯƠNG PHÁP PHẪU THUẬT TÁCH DÍNH ĐẶT KEEL THANH QUẢN: BÁO CÁO MÔ TẢ LOẠT CA

Abstract

Introduction: Anterior glottic stenosis is an abnormal fusion of the anterior bilateral vocal folds that may be congenital or acquired. Treatment is primarily surgical and can be performed by endoscopic or open approach. This study was performed to describe clinical characteristics and outcomes of patients with anterior glottic stenosis treated by web division surgery combined with laryngeal keel placement.
Methods: a case series described 6 patients with anterior glottic stenosis that were treated by web division surgery combined with laryngeal keel placement at Ho Chi Minh City University Medical Center from October 2018 to December 2022.
Results: There were 1 male and 5 females with the mean age of 48.83. 5/6 patients developed anterior glottic stenosis after endolaryngeal microsurgery for benign vocal lesions. The other patient acquired anterior glottic stenosis following vocal fold dysplasia mucosal excision. According to Cohens classification, 4 and 2 cases suffered from type II and type III, respectively. Web division surgeries combined with laryngeal keel placements were successful without any perioperative complications such as bleeding, infection, subcutaneous emphysema and rupture of keel fixation suture. 2 patients had grannuloma formation at keel site. Voice Handicap Index was used to assess outcome, with the resulting mean score of 24 (5 - 71). Self-reported voice quality improved significantly after surgery. There was no recurrent stenosis after keel removal.
Conclusion: Web division surgery combined with laryngeal keel placement is a feasible, safe and effective technique in treatment of anterior glottic stenosis.