Concepedia

Congenital Glottic Webs in Children

Annals of Otology Rhinology & Laryngology · 1985 · 179 citations · 19 references

TL;DR

The study aims to clarify controversies surrounding congenital glottic webs and propose a definitive treatment approach. The authors conducted a retrospective review of 51 pediatric cases, analyzing embryology, anatomy, literature, and patient data to evaluate various treatments—including dilatations, incisions, stenting, and external surgery with keel insertion—and comparing outcomes before and after the advent of laser surgery. Among the 51 patients, 22 required tracheotomy but all who completed therapy were decannulated; although vocal dysfunction proved difficult to resolve, the overall outcomes challenge the pessimistic views reported in the literature.

Abstract

This study is a retrospective review of congenital glottic webs in children. Its purpose is to clarify the controversial aspects of this lesion and to offer a more definitive approach to its treatment. The study includes discussions of embryology and anatomy, a thorough literature review, and a detailed statistical analysis of patient data. Fifty-one pediatric cases are reported, with symptoms and endoscopic findings described in detail. Treatment with dilatations, incisions (knife, scissors, laser), stenting, and external laryngeal surgery with keel insertion are evaluated, and results of therapy, both before and after the development of laser surgery, are reported. Of the 51 patients, 22 required tracheotomy and all who completed therapy were ultimately decannulated. Vocal dysfunction was the most difficult symptom to treat, and perfection of the voice was attained only infrequently. However, the ultimate results of therapy, as noted in this series of patients, should counter the pessimistic viewpoints expressed in the literature.