Surgical treatment of laryngeal stenosis.

In this study of the surgical treatment of acquired definite stenoses and atresia of the larynx, the author made the following classification: (i) stenoses due to bilateral paralysis of the recurrent nerve; (ii) stenoses caused by cicatrization of endolaryngeal structures, complete atresia of the larynx with obliteration of the lumen (a) the cartilaginous skeleton of the larynx is still preserved, (b) cases in whom for various reasons the cartilaginous skeleton had been destroyed and the lumen of the larynx assumed the shape of a narrow fissure covered with mucosa; and (iii) cases without cartilaginous skeleton or mucosa where only a cicatricial tissue has remained. As a basis for this research 120 cases were used. Two surgical techniques in bilateral paralysis of the recurrent nerve are described in detail. A combined extra- and intralaryngeal method of submucosal exenteration of the larynx and arytenoidectomy on one half, and cordopexy and disarticulation of the arytenoid was carried out on 30 patients. The second technique, which is still in a clinically experimental phase, is called arytenoidectomy and cordopexy via intercricothyroidolaryngotomy. It was used on only two patients, while greater experience has been gained through experiments carried out on animals (horses and dogs). In 22 patients treated for cicatricial stenoses and atresia various kinds of plastic reconstructive procedures were used. In all 22 patients treated for cicatricial stenoses and atresia various kinds of plastic reconstructive procedures were used. In all 120 cases the respiratory function of the larynx was satisfactorily restored. The voice of all these patients was altered and the phonatory function in 65 per cent of cases remained significantly impaired.