Congenital interarytenoid web

Abstract

Congenital interarytenoid web is a rare laryngeal anomaly whose distinctive feature is a band of tissue joining the medial surfaces of the arytenoids and restricting abduction of the vocal cords. It appears to arise from persistence of the embryonic membranous interarytenoid layers, which form the epithelial lamina of the fetal laryngeal sagittal cleft. This review of 16 cases seen in a 15-year period describes the clinical features, diagnostic evaluation, and management. In addition to the interarytenoid web, which is present to some degree in all patients, associated anomalous features may include subglottic stenosis, enlarged bulky arytenoids, and difficulty exposing the larynx and maintaining the airway during anesthesia and endoscopy. The association of these four features in this rare laryngeal anomaly has not been previously described. Diagnosis depends on direct laryngoscopy with particular attention to the posterior larynx. Tracheotomy may be required for 3 to 5 years as definitive corrective management has not been established.