Endoscopic lysis of anterior glottic webs and silicone keel placement.

OBJECTIVES

Acquired anterior glottic webs occur most commonly after endoscopic resection of laryngeal papilloma involving the anterior vocal folds. Treatment of anterior glottic webs has included a tracheotomy with laryngofissure and placement of a laryngeal stent or keel. We have used an endoscopic technique of web lysis and placement of a laryngeal keel without tracheotomy over the past 7 years.

METHODS

A retrospective chart review was conducted of all cases of endoscopic web lysis and keel placement performed by the senior author (S.A.B.).

RESULTS

Over the past 7 years, 10 patients underwent the procedure, with a mean follow-up of 18 months. The length of the anterior web was up to two thirds of the membranous vocal fold. Outcomes analysis revealed a recurrence in 1 patient and 2 minor complications necessitating treatment.

CONCLUSIONS

Endoscopic web lysis and keel placement offers superior results with less morbidity compared to open techniques.