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)