Postlaryngectomy supraglottic stenosis revealed by three-dimensional computed tomography reconstruction: A case report

Medicine (Baltimore). 2022 Feb 4;101(5):e28769. doi: 10.1097/MD.0000000000028769.

Abstract

Rationale: Supraglottic stenosis is a rare cause of airway obstruction. It can be induced by radiation, trauma, autoimmune diseases, or caustic exposure, and is often misdiagnosed as asthma. Detailed airway information is necessary to re-establish the normal functioning of the airway.

Patient concerns: A 78-year-old woman with severe dyspnea and hypercarbia was scheduled for surgery to resolve airway obstruction, previously known as supraglottic stenosis.

Diagnoses: To determine the exact internal shape of the stenotic lesion, we reconstructed three dimensional computed tomography (CT) images depicted a tubular supraglottic stenosis.

Interventions: The patient underwent tracheotomy under monitored anesthesia care and local anesthesia, followed by general anesthesia. For long-term management of the patient, the otorhinolaryngologist excised the supraglottic stricture via micro-laryngeal surgery using a CO2 laser and applied mitomycin to prevent further obstruction.

Outcomes: The patient recovered uneventfully after anesthesia, and symptom due to supraglottic stenosis was improved.

Lessons: During airway management of patients with postlaryngectomy supraglottic stenosis, three-dimensional reconstructed computed tomography images facilitate airway configuration in addition to endoscopy and other radiological findings.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Airway Obstruction* / diagnostic imaging
  • Airway Obstruction* / etiology
  • Airway Obstruction* / surgery
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Female
  • Humans
  • Laryngostenosis* / diagnostic imaging
  • Laryngostenosis* / etiology
  • Laryngostenosis* / surgery
  • Tomography, X-Ray Computed