대한기관식도과학회지 (Korean Journal of Bronchoesophagology)

대한기관식도과학회 (The Korean Bronchoesophagological Society)
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KTP-532 레이저에 의한 성문상부 협착증 치험

Endoscopic Management of Supraglottic Stenosis with KTP-532 Laser

  • 최종욱 (고려대학교 이비인후-두경부외과학교실) ;
  • 전병선 (고려대학교 이비인후-두경부외과학교실) ;
  • 강희준 (고려대학교 이비인후-두경부외과학교실) ;
  • 백승국 (고려대학교 이비인후-두경부외과학교실) ;
  • 최건 (고려대학교 이비인후-두경부외과학교실) ;
  • 정광윤 (고려대학교 이비인후-두경부외과학교실) ;
  • 주형로 (고려대학교 이비인후-두경부외과학교실)
  • Choi, Jong-Ouck (Department of Otolaryngology-Head and Neck Surgery College of Medicine, Korea University) ;
  • Jun, Byung-Sun (Department of Otolaryngology-Head and Neck Surgery College of Medicine, Korea University) ;
  • Kang, Hee-Joon (Department of Otolaryngology-Head and Neck Surgery College of Medicine, Korea University) ;
  • Baek, Seung-Kuk (Department of Otolaryngology-Head and Neck Surgery College of Medicine, Korea University) ;
  • Choi, Geun (Department of Otolaryngology-Head and Neck Surgery College of Medicine, Korea University) ;
  • Jung, Kwang-Yoon (Department of Otolaryngology-Head and Neck Surgery College of Medicine, Korea University) ;
  • Chu, Hyung-Ro (Department of Otolaryngology-Head and Neck Surgery College of Medicine, Korea University)
  • 발행 : 1999.12.01
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초록

Background and Objectives : The treatment of supraglottic stenosis remains a challenging problem in the field of otolaryngology due to its association with dyspnea, dysphagia, and frequent recurrence. Any satisfactory treatment is not yet known. The author experienced six cases of supraglottic stenosis and report the successful treatment of five cases by repeated endoscopic laryngeal excision with KTP-532 laser under suspension layngoscopy. Materials and Methods : Six adults who were treated for supraglottic stenosis between March 1994 and December 1998 at the Department of Otoloaryngology-Head and Neck Surgery, Korea University Medical Center were studied retrospectively. The patients were placed under general anesthesia followed by endoscopic laryngeal excision with KTP-532 laser under supension laryngoscopy. The scar tissue and granulation tissue were visualized with an operating microscope, and then removed using KTP-532 laser (15watts, continuous mode). Intraoperative local steroid(Triamcinolone ) was injected in all cases after the stenotic portions were removed. Results : Endoscopic excision was performed in five cases ; among the five cases, cricoid cartilage was concomitantly removed in two cases, and epiglottis was removed in one case. Satisfactory swallowing and airway respiration were possible in all five patients who underwent endoscopic widening. Conclusion : The treatment of supraglottic stenosis is different from that of tracheal or glottic stenosis in that supraglottic stenosis is mainly developed in membraneous form. Repeated laser excision and local steroid injection under suspension laryngoscopy is an effective and recommend able method for the treatment of supraglottic stenosis.

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