Microtrapdoor Flap Technique for Treatment of Glottic Laryngeal Stenosis: Experience With 34 Cases

Abstract

Laryngeal stenosis is the most challenging disorder for the laryngologist to treat. Microtrapdoor flap technique was described in 1980s; however, it has not been popular since then. The reason may be the difficulty of the technique. In this study, we will report our experience with microtrapdoor flap technique to treat glottic stenosis of 34 patients. Retrospective case series of a tertiary referral center. Twelve male and 22 female patients make up our study group. All patients, but one, had pure glottic stenosis. The other patient had combined supraglottic and glottic stenosis. Unilateral or bilateral microtrapdoor technique was applied to all patients. The patients are required to have at least 1year postoperative follow-up. The etiology of glottic stenosis includes 19 cases due to failed surgery for bilateral vocal fold paralysis; seven cases due to microlaryngoscopy (three laryngeal papilloma, one leukoplakia excision, one glottic cancer excision, one foreign body extraction, one biopsy from interarytenoid region); four cases due to prolonged intubation; one case due to laryngeal fracture, one case due to vertical laryngectomy, one case due to smoke inhalation (burn), and one case congenital or idiopathic. Seventeen patients had tracheotomy. All seventeen of them were decannulated 2months postoperatively. Thirty-three patients (97%) were dyspnea free on exertion 1year postoperatively. One patient developed restenosis and dyspnea 1year after treatment; she needs retreatment. Microtrapdoor flap technique is a successful surgical option for treatment of short-segment laryngeal stenosis.