Surgical treatment of glottic web using butterfly mucosal flap technique: Experience on 12 patients

Many surgical methods have been described for the treatment of glottic web, with very little experience of each. Butterfly mucosal flap technique utilizes superior and inferior mucosal flaps on corresponding surfaces of the web; superior flap is elevated with its base on one vocal fold; and inferior flap is elevated with its base on the other vocal fold. These flaps are sutured to the vocal fold where flap's base is located. This requires four to six microsutures. The disadvantage of this technique is its difficulty. The advantages are single-stage endoscopic outpatient surgery and high success rate.

This is an individual prospective cohort study. All consecutive 12 cases of glottic web were treated with butterfly mucosal flap technique and followed for at least 1 year postoperatively. Voice Handicap Index (VHI)-30 including physical, functional, emotional, and total scores; acoustic analysis with /a/; aerodynamic measures; and respiratory function tests with a spirometer were determined pre- and postoperatively.

Six patients were male; five were female; and one was male-to-female transsexual. Their ages ranged between 9 and 60 years with a mean of 36. All webs were caused by surgical trauma. All webs were cured with one surgery. The postoperative VHI scores, acoustic analysis results, aerodynamic measures, and respiratory function test results of patients improved significantly postoperatively (P < 0.05).

Although technically difficult, butterfly mucosal flap technique is a very successful single-stage endoscopic surgical option for the treatment of glottic webs.

2 Laryngoscope, 129:1423-1427, 2019.