Posterior glottic stenosis

Posterior glottic stenosis in children is not uncommon and must be differentiated from vocal cord paralysis when there is posterior glottic fixation. Procedures aimed at increasing the airway lumen by tissue excision have not been uniformly successful. Chronic aspiration and poor voice results have been reported. Expansion of the posterior glottis yields excellent results. Tracheotomy decannulation without aspiration and return of vocal cord mobility in children who have vocal cord fixation with achievement of a functional voice can be expected from widening the laryngeal framework. Scar incision without excision reduces the denuded laryngeal surface. The laryngeal framework is widened by anterior and posterior cricoid split and by stenting. Posterior cartilage grafting reduces scar tissue build-up and the duration of stenting. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.