Laser plasty combined with mucosal suture technique for the treatment of child vocal cord adhesion case

Abstract

A pediatric case of vocal cord adhesion treated by laser plasty combined with mucosal suture technique was reported. A 3 year and 7 month old girl was referred to our clnic with prolonged stridor for more than 2 years. Fiberoptic observations revealed a limitation of the opening of the glottis during inspiration and a tentative diagnosis of bilateral laryngeal paralysis was made. However, microlaryngoscopy performed after tracheostomy under general anesthesia revealed an adhesion of both vocal cords for the anterior 4/5. The adhesion was separated with C02 laser, and the right vocal cord was laterally fixed according to the Ejnell method. One month after the surgery, however, the adhesion recurred. Therefore, under microlaryngoscopy, the ashesion was separated again and the cut end of the right vocal cord was thinned using a laterally beamed laser tip to leave the upper and lower mucosal edges intact. Both mucosal edges were then sutured together to close the raw surface at the cut end by means of our mucosal suture technique reported elsewhere. The entire procedures were made with a supportive viewing of the surgical field using an angurated telescope attached to the operating table.