Congenital glottic webs in children. A retrospective review of 51 patients.

This study is a retrospective review of congenital glottic webs in children. Its purpose is to clarify the controversial aspects of this lesion and to offer a more definitive approach to its treatment. The study includes discussions of embryology and anatomy, a thorough literature review, and a detailed statistical analysis of patient data. Fifty-one pediatric cases are reported, with symptoms and endoscopic findings described in detail. Treatment with dilatations, incisions (knife, scissors, laser), stenting, and external laryngeal surgery with keel insertion are evaluated, and results of therapy, both before and after the development of laser surgery, are reported. Of the 51 patients, 22 required tracheotomy and all who completed therapy were ultimately decannulated. Vocal dysfunction was the most difficult symptom to treat, and perfection of the voice was attained only infrequently. However, the ultimate results of therapy, as noted in this series of patients, should counter the pessimistic viewpoints expressed in the literature.