Congenital laryngeal webs: Surgical course and outcomes

Document Type

Journal Article

Publication Date

1-1-2010

Journal

Annals of Otology, Rhinology and Laryngology

Volume

119

Issue

10

DOI

10.1177/000348941011901010

Keywords

22q11 deletion; Airway reconstruction; Laryngeal web

Abstract

Objectives: We compare the success of different surgical options in the treatment of laryngeal webs. Methods: We performed a retrospective study spanning the years 1980 to 2005. Results: Eighteen patients were identified. The average age at diagnosis was 6 months (range, 1 day to 2.5 years). The presenting symptoms included weak cry, stridor, airway obstruction, and difficulty breathing. Associated cardiac defects consistent with the diagnosis of 22q-syndrome were present in 7 patients. Webs were classified as grade I (5 patients), grade II (2 patients), grade III (10 patients), or grade IV (1 patient) according to the Cohen classification. In 5 patients, only endoscopic lysis was required. The remaining 13 patients underwent open procedures; 9 patients in this group required tracheotomy. An average of 1.3 open airway procedures was necessary to achieve a decannulation rate of 89%. After operation, 34% of patients had residual webbing and 20% had a weak or aphonic voice. Conclusions: Management of laryngeal webs is dependent on the severity of airway obstruction. Grade I and II webs can be treated endoscopically; more severe laryngeal webs usually require tracheotomy and open airway reconstruction. © 2010 Annals Publishing Company. All rights reserved.

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