Two Cases of Laryngeal Web Treated by Silicon Plate Detention in Laryngomicrosurgery

Abstract

Two cases of laryngeal web were treated with laryngomicrosurgery. Laryngeal webs were cut off by KTP laser and silicon plates were placed at the anterior part of glottis. These silicon plates were fixed by nylon thread through the surface of the skin on the neck and were intended to be in place for three weeks.
Both cases had good outcomes in the improvement of their webs. The first patient had their silicon plate removed two weeks after the operation because they felt something wrong in the larynx. A knot of the thread through the neck skin had slid into larynx and the knot seemed to have stimulated the laryngeal mucosa.
The second patient's silicon plate came off the day after the operation. A follow up treatment was per-formed three days after defluxion. During this procedure, the plate was trimmed to nearly half its original size to prevent suffocation if the plate were to come off and heavier thread was used to avert thread breakage. Two knots were made concurrently at the top and bottom of silicon plate in order to avoid the thread sliding into the larynx. Three weeks after the first operation this second resized plate was re-moved.
Plate defluxion will cause death by suffocation. In first place, reliable fixation is desirable. Secondary, we should make all efforts to eliminate the possibility of suffocation if plate defluxion were to occur.