Congenital laryngeal webs: surgical course and outcomes.
OBJECTIVE
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.
Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee, USA.
Steven
S
Goudy
Nancy
N
Bauman
José
J
Manaligod
Richard J H
RJ
Smith
D000015:Abnormalities, Multiple; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007828:Laryngoscopy; D007830:Larynx / Q000002:abnormalities* / Q000601:surgery*; D012189:Retrospective Studies; D014140:Tracheotomy; D016896:Treatment Outcome