[Determination of the rational extent of laser-assisted resection for the treatment of paralytic laryngeal stenosis].

The objective of the present study was to improve the procedures for extended and restricted laser-assisted laryngoplasty in the patients presenting withparalytic laryngeal stenosis and to evaluate the outcome of the surgical interventionsdiffering in extent. The study included 51 patients (47 women and 4 men) at the age varying from 18 to 78 years. Twenty five of these patients had a tracheostoma. The examination was focused on the detection of the following characteristics: vocal fold angle, body mass index, age, specific anatomical and physiological features of the larynx, clinically significant concomitant pathologies, engagement in voice and speech professional activities as well as the influence of paramedical factors. The resulting total score was calculated. The data obtained were used to rationally plan the laser-assisted resection (either extended or restricted)of the posterior third of a vocal fold. The total score of 6 or higher always implied the necessity of extended resection whereas the overall score of 3 and less was regarded as an indication for the tissue-sparing surgery. The patients to whom the extended resection was prescribed had significantly higher physical health indices and the worse vocal function compared with the same parameters in the patients undergoing restricted resection. The spirometric characteristics of the patients in both groups were similar and either normal or slightly reduced. The characteristics of the psychic component of general health were not significantly different and corresponded to the internationally accepted normal values. It is concluded that the proposed treatment resulted in the favourable outcome in 49 of the 51 patients (96%).