ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025
Bi-layered microflap surgery for the treatment of anterior glottic web.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAnterior glottic webs are epithelium-covered fibrous tissue formations at the anterior commissure, leading to synechiae between the bilateral vocal folds. They manifest with symptoms ranging from hoarseness to airway obstruction. However, treating anterior glottic webs are challenging due to their high recurrence rates. In this study, we report our treatment outcomes using the bi-layered microflap surgery.
methodsThis retrospective case series analyzed nine patients with anterior glottic webs from a tertiary medical center. All patients underwent the bi-layered microflap technique for the treatment of anterior glottic webs under the setting as microlaryngeal surgery. The primary treatment outcome was the web length ratio (relative to vocal fold length), while secondary outcomes included the Voice Handicap Index-10 (VHI-10), smoothed Cepstral Peak Prominence (CPPs), and GRB scores.
resultsThe nine patients comprised five men and four women aged 32 to 71 years, with a mean of 48.6 years. The average web length ratio decreased from 56.9 ± 20.0% to 35.2 ± 13.7%. VHI-10 scores improved from 31.9 ± 7.5 to 16.8 ± 10.1. CPPs increased from 6.4 ± 3.1 to 8.4 ± 3.1, and GRB scores (summation) decreased from 5.4 ± 1.0 to 3.7 ± 1.8 (p < 0.05, Wilcoxon signed-ranks test).
conclusionThe bi-layered microflap technique is an effective method for managing anterior glottic webs. This single-stage, stent-free endoscopic procedure results in a statistically significant decrease in web length ratio, VHI-10, CPPs, and GRB scores.
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