Plate V Laryngeal And Tracheal Stenoses:

Sources: A Manual Of Peroral Endoscopy And Laryngeal Surgery

1, Indirect view, sitting position; postdiphtheric cicatricial

stenosis permanently cured by endoscopic evisceration. (See Fig. 5.)

2, Indirect view, sitting position; posttyphoid cicatricial stenosis.

Mucosa was very cyanotic because cannula was re-moved for laryngoscopy

and bronchoscopy. Cured by laryngostomy. (See Fig. 6.) 3, Indirect

view, sitting position; posttyphoid infiltrative stenosis, left

arytenoid destroyed by necrosis. Cured by laryngostomy; failure to

form adventitious band (Fig. 7) because of lack of arytenoid activity.

4, Indirect view, recumbent position; posttyphoid cicatricial

stenosis. Cured of stenosis by endoscopic evisceration with sliding

punch forceps. Anterior commissure twice afterward cleared of

cicatricial tissue as in the other case shown in Fig. 15. Ultimate

result shown in Fig. 8. 5, Same patient as Fig. 1; sketch made two

years after decannulation and plastic. 6, Same patient as Fig. 2;

sketch made four years after decannulation and plastic. 7, Same

patient as Fig. 3; sketch made three years after decannulation and

plastic. 8, Same patient as Fig. 4; sketch made one year after

decannulation, fourteen months after clearing of the anterior

commissure to form adventitious cords. 9, Direct view, recumbent

patient; web postdiphtheric (?) or congenital (?). Rough voice since

birth, but larynx never examined until stenosed after diphtheria. Web

removed and larynx eviscerated with punch forceps; recurrence of

stenosis (not of web). Cure by laryngostomy. This view also

illustrates the true depth of the larynx which is often overlooked

because of the misleading flatness of laryngeal illustrations. 10,

Direct laryngoscopic view; postdiphtheric hypertrophic subglottic

stenosis. Cured by galvanocauterization. 11, Direct laryngoscopic

view; postdiphtheric hypertrophic supraglottic stenosis. Forceps

excision; extubation one month later; still well after four years. 12,

Bronchoscopic view of posttracheotomic stenosis following a plastic

flap tracheotomy done for acute edema. 13, Direct laryngoscopic view;

anterolateral thymic compression stenosis in a child of eighteen

months. Cured by thymopexy. 14, Indirect laryngoscopic (mirror) view;

laryngostomy rubber tube in position in treatment of post-typhoid

stenosis. 15, Direct view; posttyphoid stenosis after cure by

laryngostomy. Dotted line shows place of excision for clearing out the

anterior commissure to restore the voice. 16, Endoscopic view of

posttracheotomic tracheal stenosis from badly placed incision and

chondrial necrosis. Tracheotomy originally done for influenzal

tracheitis. Cured by tracheostomy.]