Flexible Laser Bronchoscopy for Subglottic Stenosis in the Awake Patient

Objective: To describe our technique and experience of treating adult subglottic stenosis using the Nd:YAG laser through a flexible bronchoscope via a fiberoptic delivery system. Design: Retrospective chart review. Patients: This study included 16 patients with subglottic stenosis who presented to the senior surgeon (M.R.R.) for laser bronchoscopy from January 2000 to December 2006. Main Outcome Measures: Progression toward decannulation and preoperative and postoperative symptoms were assessed. Results: Four of 7 patients who required tracheostomy tubes at the start of laser bronchoscopy underwent decannulation. None of the remaining 9 patients required tracheostomy tubes during treatment. All patients had improvement in their symptoms. Complications of the procedure were minimal. Conclusions: Bronchoscopy with the Nd: YAG laser is a well-tolerated and effective treatment for subglottic stenosis. Laryngotracheal trauma caused by an endotracheal tube and/or rigid bronchoscope is avoided. This procedure may be useful to achieve and maintain a patent airway. Arch Otolaryngol Head Neck Surg. 2009; 135(5): 467-471