Flexible laser bronchoscopy for subglottic stenosis in the awake patient

Arch Otolaryngol Head Neck Surg. 2009 May;135(5):467-71. doi: 10.1001/archoto.2009.28.


Objective: To describe our technique and experience of treating adult subglottic stenosis using the Nd:YAG laser through a flexible bronchoscope via a fiberoptic delivery system.

Design: Retrospective chart review.

Patients: This study included 16 patients with subglottic stenosis who presented to the senior surgeon (M.R.R.) for laser bronchoscopy from January 2000 to December 2006.

Main outcome measures: Progression toward decannulation and preoperative and postoperative symptoms were assessed.

Results: Four of 7 patients who required tracheostomy tubes at the start of laser bronchoscopy underwent decannulation. None of the remaining 9 patients required tracheostomy tubes during treatment. All patients had improvement in their symptoms. Complications of the procedure were minimal.

Conclusions: Bronchoscopy with the Nd:YAG laser is a well-tolerated and effective treatment for subglottic stenosis. Laryngotracheal trauma caused by an endotracheal tube and/or rigid bronchoscope is avoided. This procedure may be useful to achieve and maintain a patent airway.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchoscopy
  • Female
  • Glottis
  • Humans
  • Laryngostenosis / surgery*
  • Laser Therapy*
  • Lasers, Solid-State
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tracheostomy