Posterior Glottic Stenosis
Like subglottic stenosis, posterior glottic stenosis results from scarring of the airway related to damage from endotracheal intubation.(71) While subglottic stenosis can occur concurrently, posterior glottic stenosis is a distinct entity. (72) Patients typically have inspiratory stridor following extubation and/or fail to tolerate extubation. As the vocal cords are fixed and unable to move, posterior glottic stenosis is often confused for bilateral vocal cord paralysis. It is therefore important to distinguish the portions of the airway that are involved. Bogdasarian classified posterior glottic stenosis into four types. Type I is vocal process adhesion. Type II is posterior commissure stenosis. Type III is posterior commissure stenosis with unilateral cricoarytenoid ankylosis, and Type IV is posterior commissure stenosis with bilateral cricoarytenoid ankylosis.(73) Whited divided the condition into Type I with scarring in the interarytenoid plane and type II with banding between the vocal processes.(74) Posterior cartilage grafting is very successfully for alleviating posterior glottic stenosis in children and can allow return of vocal cord motion. (70-72)