Endoscopic lysis of anterior glottic webs and silicone keel placement

Objectives: Acquired anterior glottic webs occur most commonly after endoscopic resection of laryngeal papilloma involving the anterior vocal folds. Treatment of anterior glottic webs has included a tracheotomy with laryngofissure and placement of a laryngeal stent or keel. We have used an endoscopic technique of web lysis and placement of a laryngeal keel without tracheotomy over the past 7 years. Methods: A retrospective chart review was conducted of all cases of endoscopic web lysis and keel placement performed by the senior author (S.A.B.). Results: Over the past 7 years, 10 patients underwent the procedure, with a mean follow-up of 18 months. The length of the anterior web was up to two thirds of the membranous vocal fold. Outcomes analysis revealed a recurrence in 1 patient and 2 minor complications necessitating treatment. Conclusions: Endoscopic web lysis and keel placement offers superior results with less morbidity compared to open techniques.