ENDOLARYNGEAL SURGERY

Aim. To optimize the endosurgical treatment depending on localization and genesis of laryngeal lesion. Materials and methods. The results of treatment of 17 patients with postintubation laryngeal cicatrical stenosis, 11 – with bilateral laryngeal paresis, 120 – with benign laryngeal neoplasms were studied. Results. In case of cicatrical stenosis at the level of vocal folds, it is recommended to perform laryngolysis and laryngeal bougienage with esophageal bougies of the increasing diameter; in case of cicatrical subfold space stenosis – laryngolysis followed by bougienage and installation of T-shaped silicon endoprosthesis or autocartilage plasty. Bilateral vocal fold paresis lasting for more than 8 months leads to irreversible cicatrical transformation that along with breathing through tracheostome or presence of dyspnea can be considered as indication to reconstructive surgery directed to restoration of laryngeal patency. Conclusion. Endoscopic subtotal chordectomy and neocanalization of the larynx can be effective for treatment of bilateral recurrent nerve paresis allowing to restore patency of natural respiratory tract and sonorous voice. Endolaryngeal removal of benign laryngeal tumors using precision technique or treatment of tumor base with point electrode in “fulguration” regime permits to avoid relapses practically entirely.

Cicatrical stenosis, benign tunor, vocal fold paresis, subtotal chordectomy, laryngeal neocanalization, laryngolysis, bougienage, endoprosthesis