Laryngeal stenosis therapy in Israeli clinics is based on the widespread use of minimally invasive techniques of endoscopic laser laryngoplasty combined with stent placement. Our ENT surgeons also practice percutaneous laryngostomy and conventional open surgeries on the larynx.
Stenosis Therapy Method at Top Ichilov
Laryngeal and tracheal stenosis, or laryngeal stenosis, is a congenital or acquired condition characterized by pathological narrowing of the airways in the laryngeal area.
Congenital laryngeal stenosis occurs around the 10th week of intrauterine development due to a disruption in the formation of the laryngeal lumen and accounts for about 5% of all congenital anomalies of the airways. Acquired stenosis results from gradual morphological changes in the larynx and surrounding tissues. The causes of chronic stenosis are varied – they can include trauma and infections of the larynx, compressive effects from neoplasms, and other anomalies.
Symptoms of laryngeal stenosis include deeper inhalation compared to normal, reduced pauses between inhalation and exhalation, and decreased pulse rate. Against the backdrop of chronic hypoxia, bronchitis, emphysema, pneumonia (in children) may develop, heart size may increase, and other complications may arise. Treatment of laryngeal stenosis is performed using two methods – surgical and endoscopic.
Modern endoscopic treatment methods for laryngeal stenosis include various techniques for dilating the laryngeal lumen, laser excision of scar tissue, its removal with subsequent stenting or injections of corticosteroids into the operated area. Endoscopic treatment is indicated for small sizes of scar tissue, absence of bacterial infections, and some other complicating factors.
During laser removal of scar tissue, modern carbon dioxide endoscopic lasers are used, and the operation is divided into two stages. In the first stage, one part of the scar formation is removed, and after 2 months – the remaining part. Under the influence of the laser, the pathological fibrous tissue is vaporized, which reduces blood loss. To prevent the formation of a new scar at the site of the removed laryngeal tissues, an alkylating cytostatic agent capable of stopping cell division is applied immediately after laser excision.
Another effective endoscopic method for treating stenosis is balloon dilation using 10-14 millimeter balloons in 1 or 2 consecutive procedures (with a 7-day interval). According to our observations, patients after such a procedure demonstrate sustained remission for up to 30 months or more.
Conventional surgical treatment methods include performing tracheotomy – opening the larynx and creating an artificial pathway for air to access the lungs, bypassing the narrowed section of the larynx. This is one of the oldest surgical procedures. The first mentions of such operations can be found in historical documents dated back to the second century BC.
One of the most effective methods of performing this operation is percutaneous dilational tracheostomy. According to numerous clinical studies, this operation is comparable in effectiveness to conventional open tracheotomy but allows for smaller incisions, less trauma to the laryngeal tissues, reduces the risk of infection, and lowers treatment costs. During the operation, the surgeon places a tube in the trachea cavity using a catheter, through which the trachea communicates with the external environment. One end of the tube is brought outside and secured in the trachea cavity with a balloon cuff.
Open surgery is indicated for stenosis of grades 3-4 and includes the removal of scar tissue, as well as surgical measures to prevent scarring of the operated area and recurrence of stenosis. Cartilage grafts may be used to expand the lumen in the laryngeal area. In some cases, stents – hollow tubes of various lengths that prevent the formation of new fibrous tissue (especially often stents are used if cartilage grafts were used to expand the laryngeal lumen) – are used to stabilize the reconstructed area of the larynx. The endotracheal stent is only placed temporarily. Thus, after performing one-stage laryngotracheoplasty, it is removed after 7 days; in other cases, the stent may be removed after 3-6 months. The stents used in our clinic are made of Teflon – a durable and inert material that ensures easy removal of the stent.
After the operation, corticosteroid therapy is conducted, and the patient is monitored, which may particularly focus on preventing the development of pneumothorax and neck hematomas. Antibiotic therapy is conducted for 2-3 weeks. Every 4 weeks, the patient is recommended to undergo preventive endoscopy to monitor the position of the stent and the process of granulation tissue formation.
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Diagnosis of Laryngeal Stenosis in Israel
The diagnosis of laryngeal stenosis in Israel is based on the assessment of symptoms and data from instrumental studies, and in most cases, it takes 3-4 days.
First Day – Arrival at the Clinic
After meeting at the airport with the coordinator-translator, the patient, accompanied by them, goes for a consultation with the leading ENT specialist. The doctor conducts a primary examination and issues referrals for diagnostic procedures.
Second Day – Investigations
The second day is entirely dedicated to the examination prescribed by the doctor.
- Endoscopy of the larynx – examination of the lumen and condition of the laryngeal mucosa using a flexible tube with a miniature camera at the end (the main diagnostic method for stenosis).
- CT is used to determine the causes of stenosis (neoplasms, cartilage tissue pathologies, inflammatory processes, etc.).
- MRI is somewhat more informative than CT and, unlike the latter, does not use X-ray radiation during scanning.
Third Day – Choosing the Treatment Method
On the last day of diagnosis, the leading otolaryngologist receives the examination results, analyzes them, and selects treatment methods. They are assisted by an expert group of doctors who make decisions regarding the individual therapeutic program at a council.
- Biopsy
- Magnetic Resonance Imaging (MRI)
- X-ray
- Biopsy and histological studies
Treatment of Laryngeal Stenosis in Israel – Prices
The cost of treating laryngeal stenosis in Israel significantly differs from the cost in clinics in Canada, the UK, Western European countries, or the United States. For example, a complete course of treatment for stenosis at our medical center is 35-45% cheaper compared to Germany and the USA.
Find out all about the prices for the necessary procedures in your case from our consultants – leave a request or contact us by phone.
The Reasons for the Popularity of Top Ichilov – Our Advantages
The indicator of how effectively laryngeal stenosis is treated in Israel is the feedback from medical tourists who have already undergone therapy at Top Ichilov. In their letters, they express gratitude to the otolaryngologists of our clinic and share their impressions of Israeli medicine.
- Top Ichilov clinic employs experienced ENT specialists, each of whom has undergone extensive specialization in their field.
- Endoscopic treatment using microscopic techniques and local corticosteroid therapy not only restores the normal lumen of the larynx but also preserves (and in some cases significantly improves) vocal function.
- Modern diagnostic equipment (endoscopic, tomographic, etc.) allows for early detection of stenosis and monitoring of the patient's condition after surgical treatment.
- Every guest of the clinic receives full support from the international department and a coordinator-translator representing their interests throughout the treatment process. A personal coordinator for each patient coordinates the doctors and resolves any organizational, everyday, and language issues.