A case of traumatic glottic web

Abstract

We herein report the surgical management of traumatic severe glottic web via the laryngofissure approach. A 55-year-old woman underwent tracheostomy due to traumatic upper airway constriction. Thick glottic web was found, and the airway had been further narrowed in the anterior-posterior dimension due to thyroid cartilage fracture. Microlaryngeal surgery was performed, resulting in the recurrence of glottic web. Thereafter, a second surgery was performed via the staged laryngofissure approach. After resection of the glottic web, the superior and inferior stump were sutured together, and the anterior stump was sutured to the cervical skin in order to enlarge the anterior-posterior dimension of the airway. Four weeks after stenting to prevent web recurrence, the laryngofissure was closed. This approach resulted in no recurrence of glottic web, expansion of the airway, or decannulation. Since microlaryngeal surgery is minimally invasive, glottic web is generally treated with microlaryngeal surgery. However, the laryngofissure approach is still useful for managing refractory thick glottic web.