Pharyngeal stenosis secondary to adenotonsillectomy. How do we solve it?

Abstract

Pharyngeal stenosis is a very rare complication of adenotonsillectomy. It is caused by a narrowing of the upper aerodigestive pathway secondary to the total or partial ad- hesion of the retropharyngeal structures as a result of extensive dissection during ton- sillectomy. Our aim is to present three consecutive clinical cases of pharyngeal stenosis after adenotonsillectomy, discuss its treatment and corresponding surgical technique. We present three infants with adenotonsillectomy with postoperative pharyngeal steno- sis. All had severe snoring, oral breathing and hyponasal resonance. The nasofibroscopy showed pharyngeal obliteration in several degrees. All patients underwent scar tissue resection and pharyngoplasty with myomucosal flap and subsequent use of pharyngeal bulb. The use of pharyngeal flaps after release of pharyngeal adhesions allows to pro- vide healthy tissue to row areas, avoiding new postoperative adhesions and providing adequate oronasal permeability. The pharyngeal bulb is essential to maintain permeabi- lity and management of scarring in the postoperative period. The technique of lateral pharyngeal flap, which aims to interpose healthy pharyngeal mucosa to cover the bloody bed, is an effective therapeutic alternative to solve post-surgical pharyngeal stenosis.