Congenital laryngeal webs: From evaluation to surgical management

Objective: To discuss the presentation, evaluation, and management of congenital laryngeal webs. Methods: The Institutional approved this retrospective review of all patients who were diagnosed with laryngeal webs at our institution within the past 10 years. Results: There were 3 type I and II webs and 7 type III and IV webs; All 3 children with type I and II laryngeal webs recovered after a single endoscopic procedure, while children with type III and IV laryngeal webs usually had a record of multiple visits to the hospital with multiple treatments. In all 7 children with type III and IV webs, a tracheotomy was performed. The average age of the patients who underwent tracheotomy was 4.86 months（range，1-11mo）. Six of the seven children (85.7%) with type III and IV webs displayed subglottic stenosis. The ultimate treatment for such patients was open laryngoplasty. Conclusions: children with type III and IV laryngeal webs were more likely to have subglottic stenosis and needed to undergo tracheotomy earlier. They usually had a record of multiple visits to the hospital with multiple treatments. Open laryngoplasty combined with the implantation of a T-tube and reconstruction of the cricoid cartilage using hyoid bone may play a crucial role in the treatment of congenital laryngeal webs with subglottic stenosis.