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[Endoscopic keel placementto treat and prevent-bilateral vocal cord adhension]
1Department of Otorhinolaryngology Head and Neck Surgery, Eye Ear Nose Throat Hospital of Fudan University, Shanghai, 200031, China.
Abstract:
Objective: To investigate the effectiveness of endoscopic keel placement for the prevention and treatment of bilateral vocal cord adhesion. Method: There are 47 cases with bilateral vocal cord lesions and 38 cases with laryngeal adhesion in this study. Bilateral vocal cord lesions were removed and laryngeal adhesion was cut and divided. Afterwards, a silicone keel was placed in each case using a Lichtenberger endo-extralaryngeal needle carrier. The keel was removed 4 weeks post-surgery and the vocal cords were observed using a laryngoscopy monthly. Result: During the 1-year follow-up, 39 (83.0%) cases with bilateral vocal cord lesions and 28(73.7%) cases with laryngeal adhesion did not develop laryngeal webs. A pseudomembrane covering the vocal cords was observed at the time of keel removal in 16 cases of all. Unfortunately, 15 cases (93.75%) developed laryngeal webs among them. However, in the cases without a pseudomembrane, only 3 (4.35%) cases formed glottic webs post-surgery(P<0.01). Conclusion: Endoscopic keel placement is an effective method for the prevention and treatment of bilateral vocal cord adhesion. The pseudomembrane detected at the time of keel removal is probably a risk factor for the development of glottic webs.
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