European Archives of Oto-Rhino-Laryngology

, Volume 274, Issue 10, pp 3697–3702 | Cite as

Web thickness determines the therapeutic effect of endoscopic keel placement on anterior glottic web

  • Jian Chen
  • Fang Shi
  • Min Chen
  • Yue Yang
  • Lei ChengEmail author
  • Haitao WuEmail author


This work is a retrospective analysis to investigate the critical risk factor for the therapeutic effect of endoscopic keel placement on anterior glottic web. Altogether, 36 patients with anterior glottic web undergoing endoscopic lysis and silicone keel placement were enrolled. Their voice qualities were evaluated using the voice handicap index-10 (VHI-10) questionnaire, and improved significantly 3 months after surgery (21.53 ± 3.89 vs 9.81 ± 6.68, P < 0.0001). However, 10 (27.8%) cases had web recurrence during the at least 1-year follow-up. Therefore, patients were classified according to the Cohen classification or web thickness, and the recurrence rates were compared. The distribution of recurrence rates for Cohen type 1 ~ 4 were 28.6, 16.7, 33.3, and 40%, respectively. The difference was not statistically significant (P = 0.461). When classified by web thickness, only 2 of 27 (7.41%) thin type cases relapsed whereas 8 of 9 (88.9%) cases in the thick group reformed webs (P < 0.001). These results suggest that the therapeutic outcome of endoscopic keel placement mostly depends on the web thickness rather than the Cohen grades. Endoscopic lysis and keel placement is only effective for cases with thin glottic webs. Patients with thick webs should be treated by other means.


Anterior glottic web Keel Thickness Cohen classification 



This work was funded by grants from the Science and Technology Commission of Shanghai Municipality, China (No. 15401971600, 17411962000, and 16411960600).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Otolaryngology-Head and Neck SurgeryEye, Ear, Nose and Throat Hospital, Fudan University, Shanghai Key Clinical Disciplines of OtorhinolaryngologyShanghaiPeople’s Republic of China

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