Endoscopic surgery under tubeless anesthesia and spontaneous breathing for a congenital laryngeal web in an infant: a case report.

Abstract

Congenital laryngeal webs are rare and defined as a thick epithelium-covered fibrous tissue lying between the vocal folds; the anterior glottis is the most common site of involvement, with possible extension to the subglottic region. The association with chromosome 22q11.2 deletion syndrome has been reported. Symptoms are abnormal/absent cry and airway obstruction since birth. Management strategies range from endoscopic division with cold instruments to open surgery for severe webbing. In case of endoscopic surgery, the need of tubeless anaesthesia and spontaneous breathing is fundamental to obtain the best surgical outcome. We here describe the case of a 4-month-old female patient affected by a type II glottic web according to Cohen, treated by means of simple endoscopic division in spontaneous breathing.