Endoscopic management of supraglottic laryngopharyngeal stenosis.

S tenosis of the supraglottic larynx and pharynx is an uncommon and difficult condition to treat. The most common etiologies include iatrogenic injury from oropharyngeal and supraglottic surgery, radiation therapy, prolonged intubation, trauma, caustic ingestion, and inflammatory diseases. Presenting symptoms are a function of stenosis severity and can range from dysphagia and dysphonia to potentially life-threatening airway obstruction. The optimal treatment of supraglottic laryngopharyngeal stenosis remains unclear. Historically, supraglottic stenosis was treated with open supraglottic laryngectomy. However, this was accompanied by high morbidity related to chronic aspiration and poor wound healing. More conservative techniques with reduced morbidity have recently gained favor, especially for subglottic and tracheal stenosis.We have adapted these endoscopic techniques to manage supraglottic laryngopharyngeal stenosis to provide long-term airway patency. In this report, we present our management of a series of patients using scar-releasing CO2 laser incisions of the lateral supraglottic laryngopharynx, combined with controlled radial balloon dilation and mitomycin C application as adjunctive treatment.