Congenital laryngeal webs: surgical course and outcomes.

Goudy S, Bauman N, Manaligod J, Smith RJ
Ann Otol Rhinol Laryngol. 2010 119 (10): 704-6

PMID: 21049857 · DOI:10.1177/000348941011901010

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.

MeSH Terms (10)

Abnormalities, Multiple Child, Preschool Humans Infant Infant, Newborn Laryngoscopy Larynx Retrospective Studies Tracheotomy Treatment Outcome

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