Congenital laryngeal webs: from diagnosis to surgical outcomes
Introduction: Congenital laryngeal webs are rare, may be associated with other airway abnormalities and be one of many features of microdeletion 22q11. Meticulous evaluation is imperative when deciding which surgical technique to use. The choice of appropriate stenting may be decisive to avoid persi...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | Brazilian Journal of Otorhinolaryngology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S180886942030118X |
| _version_ | 1818096853749596160 |
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| author | Melissa Ameloti Gomes Avelino Débora Bressan Pazinatto Stela Oliveira Rodrigues Rebecca Maunsell |
| author_facet | Melissa Ameloti Gomes Avelino Débora Bressan Pazinatto Stela Oliveira Rodrigues Rebecca Maunsell |
| author_sort | Melissa Ameloti Gomes Avelino |
| collection | DOAJ |
| description | Introduction: Congenital laryngeal webs are rare, may be associated with other airway abnormalities and be one of many features of microdeletion 22q11. Meticulous evaluation is imperative when deciding which surgical technique to use. The choice of appropriate stenting may be decisive to avoid persistent anterior commissure synechia and poor voice results. Objective: To report outcomes for endoscopic and open surgical approaches in the treatment of congenital laryngeal webs and the challenges one may encounter while applying the current classification and deciding for the best treatment option. Methods: Retrospective review of medical and surgical charts for congenital laryngeal webs treated in two tertiary university centers. Results: Seven patients were included; following Cohen’s classification there were: three type II webs, one of them with an atypical posterior synechia, two type III webs and two type IV webs. Six patients were submitted to laryngotracheal reconstruction and one was treated with an endoscopic approach. Description of precise glottic and subglottic involvement and tailored surgical options are presented. The LT mold® stent was used for long-term stenting that varied between 40 to 60 days. All patients were successfully decannulated with good voice quality and after follow-up of over one year, there were no complications associated with the surgeries. Conclusion: Congenital laryngeal webs should be suspected and thoroughly evaluated in the presence of neonatal dysphonia and early onset of laryngitis. Otolaryngologists must be familiar with associated lesions and genetic conditions that may be associated to congenital laryngeal webs. Congenital laryngeal webs may be successfully treated at an early age. The correct choice of surgical technique after meticulous evaluation of glottic and subglottic components of the web, presence of concomitant lesions and appropriate stenting, is imperative to avoid persistent scarring and poor voice quality. |
| first_indexed | 2024-12-10T23:11:14Z |
| format | Article |
| id | doaj.art-33e367d2f7d349a9bd013174aa3b846f |
| institution | Directory Open Access Journal |
| issn | 1808-8694 |
| language | English |
| last_indexed | 2024-12-10T23:11:14Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Otorhinolaryngology |
| spelling | doaj.art-33e367d2f7d349a9bd013174aa3b846f2022-12-22T01:29:56ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942022-07-01884497504Congenital laryngeal webs: from diagnosis to surgical outcomesMelissa Ameloti Gomes Avelino0Débora Bressan Pazinatto1Stela Oliveira Rodrigues2Rebecca Maunsell3Universidade Federal de Goiás (UFG), Departamento de Cirurgia e Serviço de Otorrinolaringologia, Goiânia, GO, BrazilUniversidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia, Campinas, SP, Brazil; Corresponding author.Universidade Federal de Goiás (UFG), Departamento de Cirurgia e Serviço de Otorrinolaringologia, Goiânia, GO, BrazilUniversidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia, Campinas, SP, BrazilIntroduction: Congenital laryngeal webs are rare, may be associated with other airway abnormalities and be one of many features of microdeletion 22q11. Meticulous evaluation is imperative when deciding which surgical technique to use. The choice of appropriate stenting may be decisive to avoid persistent anterior commissure synechia and poor voice results. Objective: To report outcomes for endoscopic and open surgical approaches in the treatment of congenital laryngeal webs and the challenges one may encounter while applying the current classification and deciding for the best treatment option. Methods: Retrospective review of medical and surgical charts for congenital laryngeal webs treated in two tertiary university centers. Results: Seven patients were included; following Cohen’s classification there were: three type II webs, one of them with an atypical posterior synechia, two type III webs and two type IV webs. Six patients were submitted to laryngotracheal reconstruction and one was treated with an endoscopic approach. Description of precise glottic and subglottic involvement and tailored surgical options are presented. The LT mold® stent was used for long-term stenting that varied between 40 to 60 days. All patients were successfully decannulated with good voice quality and after follow-up of over one year, there were no complications associated with the surgeries. Conclusion: Congenital laryngeal webs should be suspected and thoroughly evaluated in the presence of neonatal dysphonia and early onset of laryngitis. Otolaryngologists must be familiar with associated lesions and genetic conditions that may be associated to congenital laryngeal webs. Congenital laryngeal webs may be successfully treated at an early age. The correct choice of surgical technique after meticulous evaluation of glottic and subglottic components of the web, presence of concomitant lesions and appropriate stenting, is imperative to avoid persistent scarring and poor voice quality.http://www.sciencedirect.com/science/article/pii/S180886942030118XChildCongenital laryngeal anomalyCongenital laryngeal webSurgical procedure |
| spellingShingle | Melissa Ameloti Gomes Avelino Débora Bressan Pazinatto Stela Oliveira Rodrigues Rebecca Maunsell Congenital laryngeal webs: from diagnosis to surgical outcomes Brazilian Journal of Otorhinolaryngology Child Congenital laryngeal anomaly Congenital laryngeal web Surgical procedure |
| title | Congenital laryngeal webs: from diagnosis to surgical outcomes |
| title_full | Congenital laryngeal webs: from diagnosis to surgical outcomes |
| title_fullStr | Congenital laryngeal webs: from diagnosis to surgical outcomes |
| title_full_unstemmed | Congenital laryngeal webs: from diagnosis to surgical outcomes |
| title_short | Congenital laryngeal webs: from diagnosis to surgical outcomes |
| title_sort | congenital laryngeal webs from diagnosis to surgical outcomes |
| topic | Child Congenital laryngeal anomaly Congenital laryngeal web Surgical procedure |
| url | http://www.sciencedirect.com/science/article/pii/S180886942030118X |
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