Methods
After discussion, our department decided to perform adhesion incision
and pharyngoplasty with CO2 laser.After the laryngeal surface anesthesia
with fiber bronchoscope, the patient was intubated awake with the light
stick. After general anesthesia, the patient was placed in a head back
and supine position. Under the microscope, a moist cotton pledget was
placed around the anesthesia cannula with a diameter of about 6mm to
protect the anesthesia tube balloon. Before incision, the
anesthesiologist was informed to change the anesthetic gas to mixed gas.
CO2 laser (2W, continuous mode) (DEKA SmartXide2C60
M103F1) was used to melt the mucosa on the right side of the epiglottic
lingual surface through the small hole, and we lifted the superior
mucosal flap for later use. Then we created the two-layer mucosal flaps
by dislocation incision of the inferior adhesive mucosa and turned the
mucosal flap from the pharyngeal cavity surface towards the lingual
surface. To shape the right epiglottic mucosa, a 6-0 vicryl was used to
suture the mucosal flap and the incisal margin of the lingual surface
mucosa of the epiglottis together. Then the excess mucosa was removed.
Sutured the mucosal flap on the lateral pharyngeal wall to the
peripheral edge of the mucosa to shape the hypopharynx (Fig 2). The same
went for the left side.