[Use of endoscopic placement of laryngeal stent combined with mucosal suturing of vocal fold for the treatment of laryngeal web].
OBJECTIVE
To investigate the effects of laryngeal stent combined with vocal fold mucosal suture for treating laryngeal web.


METHODS
A retrospective study performed, 21 laryngeal web cases were included in this study. The web causes were previous vocal fold surgery for benign lesions in 8 cases, previous laryngeal surgery for recurrent papilloma in 6 cases, laryngeal trauma in 6 cases, and congenital web in 1 case. Fifteen adults received glottic silastic sheet keels placement with vocal fold suture, another 2 adults and 4 children only had vocal fold suture, the above procedures were performed with laryngeal endoscopy.


RESULTS
Among all patients, good glottis shape was achieved and good voice maintained, 6 months to 3 years follow-up showed open airway without restenosis. 15 adults who had both keels placement and vocal cord suture tolerated the keel well. Keel removal under direct laryngoscopy was performed 3-4 weeks after surgery. A normal triangular shaped glottis anterior commissure anatomy was restored in 14 patients and 2-3 mm residual webbing was found in 1 patient (who had laryngofissure history). 2-3 mm residual webbing was found in 4 children who only had endoscopic vocal fold suture. After receiving endoscopic vocal fold suture, 2 adults who was found to have 2-3 mm normal mucosal membrane in anterior commissure during surgery, restored normal vocal cord shape.


CONCLUSIONS
The study shows that silastic keel placement combined with vocal fold mucosal suture was successful for treating laryngeal webs cases. Mucosal suturing of vocal fold may decrease or eliminate raw surface exposure and it is useful in the management of pediatric laryngeal webs and webs with normal mucosal membrane in anterior commissure. The potential benefits of those procedures are in avoiding long-term glottic stenting, laryngofissure, and tracheotomy.
Xu
Wen
W
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China. entwen@trhos.com
Han
De-min
DM
Li
Hong-yan
HY
Chen
Xue-jun
XJ
Yang
Qing-wen
QW
Hou
Li-zhen
LZ
Zhang
Li
L
Ye
Jing-ying
JY
Wang
Jun
J
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012826:Silicone Elastomers; D014827:Vocal Cords / Q000601:surgery*; D055815:Young Adult
D012826:Silicone Elastomers