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Plate V Laryngeal And Tracheal Stenoses:

Source: 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.]

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