Succinct key points:
- Ten patients who has congenital laryngeal web were included .
- There were 3 type I、II webs, 7 type III、IV web。
- All the 3 children with type I and II laryngeal web recovered after a
single endoscopic procedure.
- children with laryngeal web type III and IV usually had a record of
multiple visits to the hospital with multiple treatments.
- The ultimate treatment required for such patients was open
laryngoplasty.
The congenital laryngeal web is a rare form of clinical laryngeal
malformation, which was first proposed by Fleischmann in 1882. This
condition is formed by the growth of the abnormal tissues in the glottic
portion and accounts for approximately 5% 【1】of the congenital
structural malformations of the larynx. At 8-10 weeks of gestation, the
congenital laryngeal web is generally associated with embryonic
developmental disorders that may occur alone or with other clinical
syndromes, such as 22q11.2 deletion syndrome. The clinical
manifestations of this condition may differ, which depends on the degree
of involvement of the laryngeal tissues and the degree of obstruction in
the trachea.
Patients with congenital laryngeal web are clinically presented with
vocal disturbances, hoarseness, wheezing, or breathlessness. This
condition is most commonly found in the anterior coalition of the vocal
folds and often combined with stenosis below the glottis. In 1985,
Cohen[2] proposed a typology for the congenital laryngeal web, which
included the following types: i) type I, which involves a thin,
membranous laryngeal web involving <35% of the vocal folds,
ii) type II including laryngeal web tissues involving 35%-50% of the
glottic portion, iii) type III, which involves the laryngeal web tissues
comprising 50%-75% of the glottic portion, and the involvement of
usually the lower glottic portion, and iv) type IV including the
laryngeal web tissues with more than 75% of the glottic portion,
completely blocking the glottis.