CO2 laser treatment for traumatic laryngeal stenosis Trauma-induced laryngeal stenosis is a common disease in otorhinolaryngology, with dyspnea and dysarthria as the main symptoms, which seriously affects patients’ quality of life. The commonly used treatment methods are laryngeal laceration and T-tube implantation and dilation, which have a long treatment course, high patient pain and high restenosis incidence. A total of 24 patients were hospitalized from 1994.10 to 1998.8, 16 males and 8 females, with an average age of 26.8 years. The duration of the disease ranged from two months to ten years after the injury, including nine cases of open laryngeal trauma and 15 cases of closed laryngeal trauma. According to the laryngeal stenosis typology, supraglottic type: 5 cases, supraglottic + glottic type 4 cases, glottic type 10 cases, glottic + subglottic type 3 cases, and subglottic type 2 cases. Among the causes of laryngeal stenosis, car accidents and impact injuries were the main ones, and a small number of them were caused by medical tracheal intubation. Of the 24 patients, 10 had tracheotomy tubes and 14 without tracheotomy had I-II° dyspnea and no dyspnea after CO2 laser treatment. Among the 10 patients with tracheotomy, 5 cases were extubated after one laser treatment, and 2 cases were extubated after two or three operations, with an extubation rate of 87.5%. Among the 24 patients, all of them had different degrees of dysphonia before surgery, and their pronunciation improved significantly after laser surgery. The CO2 laser was used to remove the scar tissue under general anesthesia and laryngoscopy in patients with post-traumatic laryngeal stenosis. During the operation, different laser powers were selected according to the thickness of the scar in the larynx, generally between 5-10W. If the scar tissue is heavy and cannot be completely removed at one time, it can be removed in stages, but it is important to remove the scar tissue that affects breathing first to improve the breathing condition and facilitate intubation in the next surgery. According to the laryngeal stenosis typology, mixed scar stenosis is more difficult to manage, where the scar stenosis crosses two anatomical regions: supraglottis + supraglottis or supraglottis + infraglottis. These two types of stenosis are often more severe than scar adhesions limited to one anatomic region and are more difficult to manage. In the case of severe supraglottic scarring, a portion of the ventricular zone can be excised to widen the supraglottic region of the open larynx while applying the CO2 laser to remove the scar tissue. In the case of combined subglottic stenosis, the subglottic part of the stenosis should be released first. The laser power should be lower and the operation should be more careful when removing the subglottic scar. Selection of indications for CO2 laser treatment of laryngeal stenosis In order to improve the postoperative efficacy, a detailed medical history and treatment history should be taken before surgery and the type of laryngeal stenosis, the extent of scar formation and the presence of laryngeal cartilage dislocation should be assessed objectively and accurately by FLS, MRI, CT, etc. In 3 out of 24 patients (2 closed laryngeal trauma and 1 open laryngeal trauma.) Due to the heavy scar in the larynx, the tube could not be removed after 2 CO2 laser surgeries (later removed after laryngeal fissure molding). From MRI and FLS, it was obvious that the thyroid cartilage was misaligned after the fracture, so that the two sides of the vocal folds were not on the same level, and after the CO2 laser removal of the scar, the scar adhesions appeared again due to the misalignment of the cartilage, so the extent of the lesion and the post-traumatic treatment should be estimated in detail before surgery to choose the appropriate treatment plan. Since advanced diagnostic methods (CT, MRI) after laryngeal trauma are not yet widespread and treatment is conservative and simple in the absence of life-threatening conditions, the incidence of laryngeal stenosis is high, whether open or closed laryngeal trauma, the damage to the cartilage and mucosa of the larynx should be clarified and actively treated within a short time after the injury (up to two weeks). For those who have obvious misalignment of laryngeal thyroid cartilage, laryngectomy or dilatation should be performed immediately, so that even if stenosis occurs after surgery, the scar growth in the larynx is relatively mild and better results can be easily obtained when applying CO2 laser treatment.