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Case Reports
. 2022 Feb 7;15(2):e244263.
doi: 10.1136/bcr-2021-244263.

Laryngeal keel in severe congenital glottic web: case report and review of literature

Ramya Baburajan  1 , Vivekanandan Balakumar  2 , Prasanna Kumar Saravanam  1 , Somu Lakshmanan  1 , Arunachalam Ravikumar  1
Affiliations
Case Reports

Laryngeal keel in severe congenital glottic web: case report and review of literature

Ramya Baburajan et al. BMJ Case Rep. .

Abstract

Glottic web is an abnormal soft tissue adhesion between the vocal cords which occurs due to failure of recanalisation. Congenital glottic webs comprises 5% of laryngeal anomalies. Cohen classified glottic webs into four types based on percentage of airway obliteration. Patients with severe glottic web-grade III and grade IV present with respiratory distress, stridor, phonatory difficulties or recurrent respiratory infections warranting urgent intervention. We are presenting our experience in managing two such patients with severe congenital glottic web. Diagnosis was confirmed by fibreoptic laryngoscopy under monitored anaesthetic care. Combined endoscopic excision of web with laryngofissure approach for keel stenting. In both our patients, we have used a silicone based keel for laryngeal stenting to provide strength and prevent re-webbing. During follow-up, both patients were found to have adequate phonation and normal airway thus demonstrating this method as safe option for adequate phonatory and airway outcomes.

Keywords: congenital disorders; ear; nose and throat/otolaryngology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Fibreoptic laryngoscopy imaging showing glottic web grade III with glottis closure of 90%.
Figure 2
Figure 2
Intraoperative image showing external laryngofissure approach.
Figure 3
Figure 3
Intraoperative image showing Montgomery keel inserted through the laryngofissure.
Figure 4
Figure 4
Fibreoptic laryngoscopy imaging showing normal glottis with adequate airway.
See this image and copyright information in PMC

References

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