Frontiers of Medicine

, Volume 12, Issue 3, pp 301–306 | Cite as

Prevention of laryngeal webs through endoscopic keel placement for bilateral vocal cord lesions

  • Jian Chen
  • Yilai Shu
  • Matthew R. Naunheim
  • Min Chen
  • Lei ChengEmail author
  • Haitao WuEmail author
Research Article


Transoral microresection for treatment of vocal cord lesions involving the anterior commissure may result in anterior glottic webs. In this study, we retrospectively reviewed 54 patients who underwent microsurgery for bilateral lesions involving the anterior commissure and categorized them into two groups. The keel placement and control groups received endoscopic keel placement and mitomycin C, respectively. During the follow-up of at least 1 year, the laryngeal web formation rate significantly decreased in the keel placement group compared with that in the control group (18.6% versus 54.5%, P < 0.05). Furthermore, the voice handicap index-10 scores for patients without web formation decreased in both the keel placement and control groups (P < 0.0001 and P < 0.001, respectively). A pseudomembrane covering the vocal cords was detected in 16.3% (7 of 43) cases after keel removal. A total of 100% (7 of 7) of these cases and 2.8% (1 of 36) of the other cases formed laryngeal webs (P < 0.0001). Endoscopic keel placement could be an effective method for preventing anterior glottic webs after surgery for bilateral vocal cord diseases involving the anterior commissure. The pseudomembrane observed at the time of keel removal may imply a high risk of web formation.


glottic stenosis glottic web laryngeal keel silastic sheets anterior commissure 


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This work was funded by grants from the Science and Technology Commission of Shanghai Municipality, China (Nos. 15401971600 and 16411960600).

Supplementary material

11684_2017_549_MOESM1_ESM.pdf (80 kb)
Supplementary material, approximately 80.0 KB.


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Copyright information

© Higher Education Press and Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Otolaryngology–Head and Neck Surgery, Eye, Ear, Nose, and Throat HospitalFudan University, Shanghai Key Clinical Disciplines of OtorhinolaryngologyShanghaiChina
  2. 2.Department of Otology and LaryngologyHarvard Medical SchoolBostonUSA
  3. 3.Department of OtolaryngologyMassachusetts Eye and Ear InfirmaryBostonUSA

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