Flexible laser bronchoscopy for subglottic stenosis in the awake patient.

OBJECTIVE

To describe our technique and experience of treating adult subglottic stenosis using the Nd:YAG laser through a flexible bronchoscope via a fiberoptic delivery system.

DESIGN

Retrospective chart review.

PATIENTS: This study included 16 patients with subglottic stenosis who presented to the senior surgeon (M.R.R.) for laser bronchoscopy from January 2000 to December 2006.

MAIN OUTCOME MEASURES: Progression toward decannulation and preoperative and postoperative symptoms were assessed.

RESULTS

Four of 7 patients who required tracheostomy tubes at the start of laser bronchoscopy underwent decannulation. None of the remaining 9 patients required tracheostomy tubes during treatment. All patients had improvement in their symptoms. Complications of the procedure were minimal.

CONCLUSIONS

Bronchoscopy with the Nd:YAG laser is a well-tolerated and effective treatment for subglottic stenosis. Laryngotracheal trauma caused by an endotracheal tube and/or rigid bronchoscope is avoided. This procedure may be useful to achieve and maintain a patent airway.