Surgical Treatment Modalities for Iatrogenic Anterior Glottic Stenosis

Abstract

Objectives: The aim of this study was to describe common iatrogenic causes of anterior glottic stenosis and to investigate the surgical treatment outcomes of 3 different techniques aimed at repairing stenoses and preventing web reformation. Methods: Clinical information regarding patient demographics, presentation, etiology, treatment, and follow-up outcomes was obtained retrospectively through a review of patients’ records between April 2010 and April 2017. Voice quality was evaluated using grade, roughness, breathiness, asthenia, and strain scale and Voice Handicap Index scores. Objective acoustic parameters were collected using the Kay Elemetrics Multi-Speech program. Results: Twenty patients were included in the study. Causes of glottic web formation included chemoradiation therapy and previous laryngeal surgery for polyps or malignant tumors at the anterior commissure. Web lysis with a CO2 laser, intralaryngeal suturing, and keel placement were used in surgical treatment. Satisfactory results were achieved in 19 patients, and 1 recurrence was observed. Grade, roughness, breathiness, asthenia, and strain scale and Voice Handicap Index scores and objective voice variables for patients with Cohen type I or II webs improved significantly after the surgery. Conclusions: Treatment modalities for anterior glottic stenosis should be carefully chosen according to the etiology of the web, as well as the length and depth of the glottis involved.