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Published on: March 3, 2023
A novel puncture needle designed for endoscopic keel placement to treat anterior glottic webs
Jian Chen1, Haitao Wu1, Peijie He1
1ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Background:
Endoscopic keel placement is difficult for patients with poor laryngeal exposures.
Aims/Objectives:
To introduce a novel extra-endo laryngeal puncture technique for endoscopic keel placement to manage anterior glottic webs.
Material And Methods:
Patients with anterior glottic webs and difficult laryngeal exposure in our hospital during 2018 to 2020 were recruited in this study. After the incision of the web, a novel puncture needle modified from a maxillary sinus puncture needle was inserted into endolarynx, and could pull the suture passing along a keel from inside out. The suture was then fixated on the neck, and the keel was placed for 4 weeks. Patients were followed up for at least 1 year.
Results:
Eight patients including three men and five women were included in this study. All the patients tolerated the silicone keel well, and 7 of 8 (87.5%) patients did not have web relapses and reached remarkable voice improvements during follow-up. None of the cases needed a tracheotomy due to the dyspnea postoperatively.
Conclusions And Significance:
The novel puncture technique is an easy and effective approach to facilitate endoscopic keel placement for the treatment of anterior glottic webs and other surgical procedures requiring endolaryngeal suturing.

