Posterior glottic stenosis type I formation as a rare complication of bilateral posterior partial cordotomy

Abstract

Objective: Bilateral posterior partial cordotomy (PPC) is occasionally performed for airway enlargement in difficult cases of bilateral vocal fold immobility. To our knowledge, no previous reports of posterior glottic stenosis type I (PGS I) have been reported after bilateral PPC. We herein describe this unusual complication. Methods: A 51-year-old woman with a history of recurrent airway obstruction secondary to bilateral vocal fold immobility presented with worsening dyspnea. After more conservative treatments failed, she underwent suspension micro direct laryngoscopy (SMDL) with CO2 laser bilateral PPC which greatly improved her dyspnea and resolved the stridor. Results: One month after bilateral PPC, the patient returned with dysphonia, worsening dyspnea, stridor, and the feeling of her throat being “stuck.” Flexible laryngoscopy with videostroboscopy revealed a bridge of scar tissue spanning the glottis, restricting vocal fold movement and vibratory activity. She was returned urgently to the operating room for SMDL, with findings consistent with a PGS I. Release of the stenosis sharply and injection with triamcinolone (40 mg/ml) resulted in greatly improved airway, which she has now maintained for over 9 months. Conclusion: With the limited literature available on the risks of bilateral PPC, this case adds a new potential risk factor in the formation of a PGS I.

Keywords

• Posterior glottic stenosis
• Bilateral vocal fold immobility
• Airway obstruction