Views of a type I posterior glottic stenosis before and after lysis.[FIGURE OMITTED] Posterior glottic glot·tic adj. 1. Of or relating to the tongue. 2. Of or relating to the glottis. glottic pertaining to (1) the glottis, or (2) the tongue. stenosis (PGS PGS Pages PGS Petroleum Geo-Services PGS Planning Gain Supplement (UK land tax) PGS Parallel Giant Slalom (skiing and snowboarding competitions) PGS Plant Genetic Systems (Belgium) ) can be devastating. It is estimated to occur in 4% of patients who have been intubated for 1 week and in 14% of those who have been intubated for up to 2 weeks. (1) Postintubation laryngotracheal injuries in various locations and of varying severity have been documented in more than half of all patients who are intubated. (2) Bogdasarian and Olson described four different types of PGS; type I PGS is characterized by adhesion at the vocal process. (2) Atracheotomy-dependent 25-year-old woman presented to our laryngology laryngology /lar·yn·gol·o·gy/ (-gol´ah-je) the branch of medicine dealing with the throat, pharynx, larynx, nasopharynx, and tracheobronchial tree. lar·yn·gol·o·gy n. clinic with bilateral impairment of true vocal fold motion. Before she underwent the tracheotomy tracheotomy (trākēŏt`əmē), surgical incision into the trachea, or windpipe. The operation is performed when the windpipe has become blocked, e.g., by the presence of some foreign object or by swelling of the larynx. , she had been intubated for less than 1 week during hospitalization for treatment of injuries incurred in a motor vehicle collision. It became apparent on retrograde fiber-optic laryngoscopy that she had an adhesion between her vocal folds at the level of the vocal process (figure, A). No other significant abnormalities were detected. The patient was taken to the operating room for elective C[O.sub.2] laser lysis lysis /ly·sis/ (li´sis) 1. destruction or decomposition, as of a cell or other substance, under influence of a specific agent. 2. mobilization of an organ by division of restraining adhesions. 3. of the adhesion with the hope that it would lead to decannulation. The adhesion, as seen with a 0[degree] telescope (figure, A), was injected with steroid and divided with the C[O.sub.2] laser. Following lysis, a 70[degrees] telescope was used to examine the surgical site (figure, B and C). Dense fibrotic tissue was seen in the remnant of the adhesion. The patient was successfully decannulated 1 week later with excellent results. References (1.) Whited RE. Posterior commissure stenosis post long-term intubation intubation /in·tu·ba·tion/ (in?too-ba´shun) the insertion of a tube into a body canal or hollow organ, as into the trachea. endotracheal intubation . Laryngoscope 1983;93(10):1314-18. (2.) Bogdasarian RS, Olson NR. Posterior glottic laryngeal stenosis. Otolaryngol Head Neck Surg 1980;88(6):765-72. Melinda Davis-Malesevich, BS; Albert Merati, MD From the Department of Otolaryngology Baylor University School of Medicine, Houston (Dr. Davis-Malesevich), and the Department of Otolaryngology--Head and Neck Surgery, University of Washington School of Medicine The University of Washington School of Medicine (UWSOM) is a public medical school located in Seattle, Washington. It is a graduate school affiliated with the University of Washington, and is the only medical school in the states of Washington, Wyoming, Alaska, and Idaho. , Seattle (Dr. Merati). |
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