TY - JOUR
AU - Choi, Sukgi S.
AB - ObjectiveTo discuss the presentation, evaluation, and management of pediatric laryngeal web.Study DesignRetrospective case series.SettingSingle tertiary care center.SubjectsAll patients with laryngeal web at Boston Children’s Hospital in the past 22 years.MethodsNo exclusion criteria. Charts mined for age at presentation, presenting symptoms, degree/location of web, associated syndromes, number/type of surgical procedures, and postoperative outcomes.ResultsThirty-seven patients were included (13 male, 24 female). Average age at diagnosis was 3.7 years (0-19.5 years). Mean follow-up was 4.4 years (range, 0-16.4 years). There were 26 congenital webs (70.2%) and 11 acquired webs (29.8%). Presenting symptoms were vocal (29 patients, 78.4%) and respiratory (22 patients, 60%). Underlying syndromes or synchronous airway lesions included the following: premature (n = 5), congenital heart disease (n = 18), subglottic stenosis (n = 5), 22q11.2 deletion syndrome (n = 10), and recurrent respiratory papillomatosis (n = 4). There were 20 type 1 webs, 6 type 2 webs, 8 type 3 webs, and 3 type 4 webs; 10 had subglottic extension of the laryngeal web. Twelve patients were managed conservatively with observation. Eighty-four interventions were performed: 18 open and 66 endoscopic (sharp division, 32; dilation, 33; mitomycin C, 14; laser, 5; keel, 6; triamcinolone injection, 8; stent, 15; removal of granulation tissue, 5). Tracheotomy was required in 11 patients, and 5 patients were decannulated. Voice improved in 12 patients, with respiratory symptoms in 12 patients. Web recurred in 17 patients. One patient died due to airway complications.ConclusionsPediatric laryngeal web is an uncommon but challenging lesion. Patients need to be evaluated for comorbid syndromes and synchronous airway lesions. Management includes open and endoscopic procedures. Procedures should be tailored to the child’s presentation.
TI - Laryngeal Web in the Pediatric Population: Evaluation and Management
JF - Otolaryngology: Head and Neck Surgery
DO - 10.1177/0194599819893985
DA - 2020-02-01
UR - https://www.deepdyve.com/lp/wiley/laryngeal-web-in-the-pediatric-population-evaluation-and-management-GbKKsaP9jX
SP - 234
EP - 240
VL - 162
IS - 2
DP - DeepDyve
ER -