An endoscopic silastic kell for anterior glottic webs

Abstract

The use of a specially designed silastic keel endoscopically inserted into the larynx to prevent restenosis after division of anterior commisure webs of the larynx is described. The treatment of such webs is discussed.

Iatrogenic Aspiration of Custom-Made Keel: A Case Report

“…If the anterior glottic stenosis is more extensive than described in the earlier paragraph or when endoscopic management is unsuccessful, the scar tissue should be excised through an open laryngofissure approach and any defect should be grafted (4). Anterior glottic restenosis may occur during the healing process postoperatively.…”

Simple keel fixation technique for endoscopic repair of anterior glottic stenosis

“…A number of previously documented techniques employed multiple punctures through the larynx with various devices, including an intravenous cannula, 12 spinal needles 13 and hypodermic needles, 14 through which the suture material was introduced. A number of previously documented techniques employed multiple punctures through the larynx with various devices, including an intravenous cannula, 12 spinal needles 13 and hypodermic needles, 14 through which the suture material was introduced.…”

Intralaryngeal Approach to Laryngeal Web Using Lateralization With Silastic

“…The intralaryngeal approach can be traced back to 1924, when Haslinger inserted a silver plate after the resection of web, followed by its fixation to the skin with wire. His successors 6–11 modified his method, either by using a different material or shape for the stent or by altering the method of stent fixation. We combined the concept of intralaryngeal approach and the concept of vocal fold lateralization used in the treatment of bilateral vocal palsy proposed by Kirchner, 15 by inserting the Silastic sheet cover on one side of the vocal fold after web resection and mobilizing the fold laterally.…”

“…Most authors who used the intralaryngeal approach method in the placement of a stent chose the duration of 4 to 6 weeks, and even 2 weeks for thin laryngeal webs. 8–11 We had originally planned to remove the stent after 6 weeks. However, because of personal reasons, the patient delayed the stent removal after a total of 9 weeks.…”

“…The primary goals of management for congenital or acquired laryngeal webs are twofold: to establish a patent airway and to achieve a good voice quality. In a review of current otolaryngology literature, surgical treatments could be classified into four categories: 1) intralaryngeal resection of web and repeat lysis of adhesions 1,2 ; 2) laryngofissure, resection of laryngeal web, and placement of a keel 3–5 ; 3) intralaryngeal resection of web and placement of a plate 6–11 ; and 4) intralaryngeal mucosal flap. 12–14 Among these methods, the second category, proposed by McNaught 3 in 1950, is recognized as the treatment of choice for laryngeal webs.…”