title: Endoscopic suture retriever for endolaryngeal keel placement in treatment of anterior glottic webs.
abstract: BACKGROUND
  Endoscopic placement of a laryngeal keel has traditionally required the use of a Lichtenberger endo-extralaryngeal needle passer, which is not universally available. We discuss a safe and technically simple alternate technique using an endoscopic suture retriever through a percutaneously placed angiocatheter that obviates the need for the Lichtenberger instrument.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Two 14-gauge angiocatheters were passed through the anterior neck under telescopic visualization of the larynx. The suture retriever was inserted through the catheter and deployed within the larynx to withdraw a Prolene suture that was threaded through a Silastic keel. The keel was then tied in position over a sterile button on the anterior neck.
  
  
  RESULTS
  This procedure was performed on 2 patients with excellent outcomes in both cases.
  
  
  CONCLUSIONS
  Endoscopic keel placement is a widely used procedure for treating anterior glottic webs and requires suture passage from within the larynx to the anterior neck to secure the keel into position. This is the first report of an exo-endolaryngeal suture retriever for placement of a laryngeal keel. This technique provides a safe, reliable, and efficient alternative to endo-extralaryngeal needle puncture and uses materials that are available in many operating room settings.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Beswick
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Clark
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bergeron
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA ksung@ohns.stanford.edu.
authors.forename: C Kwang
authors.initials: CK
authors.lastname: Sung
mesh_terms: D020878:Device Removal / Q000379:methods*; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D007829:Laryngostenosis / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures
keywords: endoscopic; keel; laryngeal stenosis