Chronic stenosis occur as a result of persistent morphological changes in the larynx or neighboring areas. They usually develop slowly and gradually. Causes of chronic stenosis varied. The most common are:
Violation of the mobility of ring-arytenoid joints.
Impaired function of nizhnegortannyh nerves as a result of toxic neuritis after strumectomy, tumor compression, etc.
Cicatricial diaphragm larynx.
The tumor, tuberculosis, syphilis, scleroma.
Most often, symptoms of acute compensation corresponds to the stage of stenosis (slowing and deepening breathing, shortening or loss of pauses between inhalation and exhalation, reducing the number of pulse beats), while physical activity increased shortness of breath, and to the original state it returns to rest. In most cases, a slow and gradual increase of the stenosis increases the opportunities for adaptation of the human body, which allows the patient even in low-cost breathing without tracheostomy.
In chronicstenosis on the basis of cicatricial process violated golosoobrazovatelnaya function, with hoarseness may eventually go to Mt. Median position the vocal folds, as a rule, does not alter the sonority of voice.
In chronic stenosis of the larynx, resulting in prolonged hypoxia in patients often develop bronchitis, emphysema, children - pneumonia. There has been expanding the boundaries and hypertrophy of the heart muscle. More or less prolonged wearing tracheotomy tube in chronic stenosis of the larynx, causing in some cases on the edge of the tracheostomy in the trachea or at the lower end of the tracheotomy tube pressure ulcers, granulation or scarring, that specialize lumen of the trachea and therefore pose a greater danger.
Treatment for chronic cicatricial stenosis is often extremely difficult and not in all cases in the short term is possible to achieve the restoration of the lumen of the larynx. For this purpose we recommend the systematic expansion of the larynx with special dilator. The most reliable results are obtained laringostomiya and prolonged (over several months) with dilatation of the T-shaped rubber tubes. When the lumen of the larynx is wide enough and persistent, the introduction pipes stop and the front wall of the larynx is reduced by plastic.
The prognosis depends on the underlying disease causing the stenosis. With regard to laryngeal function is often not favorable, some patients can be surgically partially restore them.
