Severe functional laryngeal stenoses treated by endoscopic arytenoidectomy.

During the 15-year period from 1978 to 1993 we treated 17 cannulated patients suffering from dyspnea caused by bilateral recurrent laryngeal nerve palsies. The causes of palsy were struma surgery (13 cases), prolonged intubation (3 cases) and unknown (1 case). All cases were operated on by the classical endolaryngeal arytenoidectomy technique developed by Kleinsasser. All patients were able to be decanulated after arytenoidectomy: 14 cases within 1 month of surgery and 3 delayed. Four patients required replacements of their tracheotomies during the follow-up period, but this proved to be only temporary in 3 cases. After excisions of polypoid tissues or enlargement of an ipsilateral partial cordectomy, definitive closure of the tracheostome was possible. Among the retracheotomized patients, only 1 patient with multilocular stenoses has remained under treatment for the past 2 years. In all, 16 of 17 patients (93%) have remained permanently decannulated.