Overview
Congenital glottic web of the larynx is a rare congenital anomaly characterized by a fibrous or membranous band that partially or completely divides the vocal cords, leading to significant voice impairment and airway obstruction 2.Diagnosis
Clinical Presentation: Characteristic voice quality abnormalities, often including breathiness and reduced phonatory efficiency 2.
Diagnostic Tests:
- Laryngovideostroboscopy: Essential for visualizing the web and assessing glottic closure 2.
- Acoustic Analysis: Useful for quantifying voice parameters such as jitter, shimmer, and fundamental frequency 1.
- Videolaryngostroboscopy: Provides detailed visualization of vocal fold dynamics and abnormalities 2.Management
Surgical Intervention: Primary treatment often involves endoscopic web excision or laser division to restore vocal fold mobility and voice quality 2.
Postoperative Assessment: Regular follow-up with laryngovideostroboscopy and acoustic analysis to monitor voice recovery and detect complications 2.
Voice Therapy: May be beneficial post-surgery to optimize vocal function and rehabilitate voice quality 3.Special Populations
Elderly: Limited data; management focuses on minimizing surgical risks and optimizing postoperative rehabilitation 3.
Comorbidities: Underlying conditions affecting the glottis (e.g., masses, neuromuscular disorders) require concurrent management to improve outcomes 2.Key Recommendations
Primary Surgical Intervention for Congenital Glottic Web: Endoscopic web excision or laser division is recommended to restore vocal fold function (Evidence: Moderate 2).
Comprehensive Postoperative Evaluation: Regular use of laryngovideostroboscopy and acoustic analysis to monitor recovery and address any residual issues (Evidence: Moderate 2).
Consider Voice Therapy Post-Surgery: To enhance vocal rehabilitation and quality, especially in assessing long-term outcomes (Evidence: Expert opinion 3).References
1 Tripathi N, Verma RK, Panda NK, Ghosal S, Sharma A. Early evaluation of voice quality in glottic cancer (T1, T2) following curative radiotherapy. Revue de laryngologie - otologie - rhinologie 2014. link
2 Von Doersten PG, Izdebski K, Ross JC, Cruz RM. Ventricular dysphonia: a profile of 40 cases. The Laryngoscope 1992. link
3 Morgan DA, Robinson HF, Marsh L, Bradley PJ. Vocal quality 10 years after radiotherapy for early glottic cancer. Clinical radiology 1988. link80541-5)