Intralaryngeal approach to laryngeal web using lateralization with silastic.

Abstract

INTRODUCTION The primary goals of management for congenital or acquired laryngeal webs are twofold: to establish a patent airway and to achieve a good voice quality. In a review of current otolaryngology literature, surgical treatments could be classified into four categories: 1) intralaryngeal resection of web and repeat lysis of adhesions; 2) laryngofissure, resection of laryngeal web, and placement of a keel; 3) intralaryngeal resection of web and placement of a plate; and 4) intralaryngeal mucosal flap. Among these methods, the second category, proposed by McNaught in 1950, is recognized as the treatment of choice for laryngeal webs. However, the need for two separate external approaches and a tracheotomy rendered this method less desirable. Therefore the third method, using an intralaryngeal approach, is favored and is still under modification and improvisation. The advantages for this method are multiple. First, it does not require an external wound. Second, it allows the patient to maintain normal speech and deglutition function after surgery. In this report, we combined the intralaryngeal approach and the concept of lateralization proposed by Kirchner and designed a simple surgical method for the management of laryngeal webs.