Combined endoscopic and open approach in treating congenital laryngeal web

Abstract

Laryngeal webs are rare and present with varied symptoms depending on the length of the web occupying the glottis. The patients present with voice and airway problems. Advanced webs have a longer glottic length involvement and web-associated cartilaginous subglottic stenosis. Adequate treatment of a laryngeal web must restore an optimal airway and give a near normal quality of voice. Both endoscopic and open procedures are used for the treatment of congenital laryngeal webs, each having their share of advantages and drawbacks. Transoral CO2 laser was used in the initial part of the surgery to cut an advanced glottic web precisely in the midline. Subsequently, the web-associated stenosis was treated by an external cartilage expansion laryngoplasty. By combining the endoscopic and open approaches, we obtained a sharp anterior commissure and also an adequate airway lumen. This assured optimal voice and airway results.