Background Anterior glottic web is one type of laryngeal stenosis.Previous surgical methods had some drawbacks,such as large surgical trauma,long postoperative recovery time,and multiple-stage surgery.This study aimed...Background Anterior glottic web is one type of laryngeal stenosis.Previous surgical methods had some drawbacks,such as large surgical trauma,long postoperative recovery time,and multiple-stage surgery.This study aimed to explore better treatment to repair anterior glottis web.Methods We performed vocal cord mucosal flap procedure on 32 patients with anterior laryngeal webs.All subjects received vocal cord scar releasing and vocal cord mucosal flap repair and suture under general anesthesia with selfretaining laryngoscope.Results All 32 patients completed surgery in one stage,without postoperative laryngeal edema,difficulty in breathing,or other complications.After the surgery,the anterior commissure of vocal cords recovered to a decent triangle shape in 28 patients; however,in four patients there were 2 to 3 mm adhesion residuals on the anterior ends of the vocal cords,accompanied by scar appearance of bilateral vocal cords.The GRB score,voice handicap index scores,and maximum phonation time score significantly improved in all patients after the surgery.There was no evidence of recurrent laryngeal webbing in the 6-rnonth follow-up.Conclusion Vocal cords mucosal flap repair surgery has the advantages of less trauma,quick recovery,and significant improvement of the voice in the treatment of laryngeal webs.展开更多
Transoral microresection for treatment of vocal cord lesions involving the anterior commissure may result in anterior glottic webs. In this study, we retrospectively reviewed 54 patients who underwent microsurgery for...Transoral microresection for treatment of vocal cord lesions involving the anterior commissure may result in anterior glottic webs. In this study, we retrospectively reviewed 54 patients who underwent microsurgery for bilateral lesions involving the anterior commissure and categorized them into two groups. The keel placement and control groups received endoscopic keel placement and mitomycin C, respectively. During the follow-up of at least 1 year, the laryngeal web formation rate significantly decreased in the keel placement group compared with that in the control group （18.6% versus 54.5%, P 〈 0.05）. Furthermore, the voice handicap index-10 scores for patients without web formation decreased in both the keel placement and control groups （P 〈 0.0001 and P 〈 0.001, respectively）. A pseudomembrane covering the vocal cords was detected in 16.3% （7 of 43） cases after keel removal. A total of 100% （7 of 7） of these cases and 2.8% （1 of 36） of the other cases formed laryngeal webs （P 〈 0.0001）. Endoscopic keel placement could be an effective method for preventing anterior glottic webs after surgery for bilateral vocal cord diseases involving the anterior commissure. The pseudomembrane observed at the time of keel removal may imply a high risk of web formation.展开更多
基金This study was supported by a grant from the National Natural Science Foundation of China （No.81170900）.
文摘Background Anterior glottic web is one type of laryngeal stenosis.Previous surgical methods had some drawbacks,such as large surgical trauma,long postoperative recovery time,and multiple-stage surgery.This study aimed to explore better treatment to repair anterior glottis web.Methods We performed vocal cord mucosal flap procedure on 32 patients with anterior laryngeal webs.All subjects received vocal cord scar releasing and vocal cord mucosal flap repair and suture under general anesthesia with selfretaining laryngoscope.Results All 32 patients completed surgery in one stage,without postoperative laryngeal edema,difficulty in breathing,or other complications.After the surgery,the anterior commissure of vocal cords recovered to a decent triangle shape in 28 patients; however,in four patients there were 2 to 3 mm adhesion residuals on the anterior ends of the vocal cords,accompanied by scar appearance of bilateral vocal cords.The GRB score,voice handicap index scores,and maximum phonation time score significantly improved in all patients after the surgery.There was no evidence of recurrent laryngeal webbing in the 6-rnonth follow-up.Conclusion Vocal cords mucosal flap repair surgery has the advantages of less trauma,quick recovery,and significant improvement of the voice in the treatment of laryngeal webs.
文摘Transoral microresection for treatment of vocal cord lesions involving the anterior commissure may result in anterior glottic webs. In this study, we retrospectively reviewed 54 patients who underwent microsurgery for bilateral lesions involving the anterior commissure and categorized them into two groups. The keel placement and control groups received endoscopic keel placement and mitomycin C, respectively. During the follow-up of at least 1 year, the laryngeal web formation rate significantly decreased in the keel placement group compared with that in the control group （18.6% versus 54.5%, P 〈 0.05）. Furthermore, the voice handicap index-10 scores for patients without web formation decreased in both the keel placement and control groups （P 〈 0.0001 and P 〈 0.001, respectively）. A pseudomembrane covering the vocal cords was detected in 16.3% （7 of 43） cases after keel removal. A total of 100% （7 of 7） of these cases and 2.8% （1 of 36） of the other cases formed laryngeal webs （P 〈 0.0001）. Endoscopic keel placement could be an effective method for preventing anterior glottic webs after surgery for bilateral vocal cord diseases involving the anterior commissure. The pseudomembrane observed at the time of keel removal may imply a high risk of web formation.
