The anterior laryngeal webs.

Anterior laryngeal webs can be congenital or acquired and occur secondary to a surgical procedure, intubation, or infection. Clinical presentation can include vocal and respiratory symptoms. The first step in managing a laryngeal web is performing flexible laryngoscopy, followed by a direct laryngoscopy under general anesthesia. Treatment remains a challenge. Endoscopically, the web can be incised with cold instruments or by laser, mitomycin-C can be applied, and a silastic keel can be inserted in the anterior commissure. Externally, an anterior cricothyrotomy is necessary and a silastic keel can be placed; anterior cartilage graft can be inserted in case of a thick web. Regardless of the technique used, the primary concern is recurrence.