Endoscopic Versus Open Surgical Intervention for Congenital Laryngeal Webs: A Systematic Review and Meta-Analysis

Abigail E. Moore; Austin Walker; Sohit Paul Kanotra

doi:10.1002/ohn.279

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Endoscopic Versus Open Surgical Intervention for Congenital Laryngeal Webs: A Systematic Review and Meta-Analysis

Journal article

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Peer reviewed

Endoscopic Versus Open Surgical Intervention for Congenital Laryngeal Webs: A Systematic Review and Meta-Analysis

Abigail E. Moore, Austin Walker and Sohit Paul Kanotra

Otolaryngology-head and neck surgery, Vol.169(2), pp.227-233

08/01/2023

DOI: 10.1002/ohn.279

PMID: 36939597

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Abstract

ObjectivesTo examine and compare the outcomes of various surgical interventions for congenital laryngeal webs in terms of avoidance of tracheostomy, rate of decannulation, web recurrence, revision surgery, and mortality in children. Data SourcesFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted on December 10, 2021, using a comprehensive search in PubMed, Web of Science, Cochrane library, and Embase with no date restriction. Review MethodsArticles on surgical intervention for congenital laryngeal webs in pediatric (<18 years) patients were included in the analysis. Articles including acquired laryngeal webs, no surgical intervention, or exclusively adult population were excluded. Results9027 articles were reviewed, 24 articles met the inclusion criteria and 126 patients were included. In patients with Grades I and II webs, there was no significant difference in rates of tracheostomy or decannulation, between endoscopic (100%) versus open approach (100%). For Grades III and IV webs, 96% of patients who received open surgery were decannulated or avoided tracheostomy compared to 84% of those managed endoscopically (p = 0.081). There were significantly lower rates of revision surgery in the open group compared to the endoscopic group (77.8% vs 30.9%, p = 0.008). ConclusionThis study showed no difference in rates of tracheostomy, decannulation, web recurrence, revision, or mortality between endoscopic and open approaches for the treatment of Grades I and II webs. For Grades III and IV, open surgical techniques achieved a lower revision rate. Results should be interpreted in light of associated increased morbidity with open procedures.

airway

congenital

endoscopic

keel

laryngeal web

larynx

laser

obstruction

pediatric

reconstruction

stridor

systematic review

tracheostomy

voice

UIOWA OA Agreement

Details

Title: Subtitle: Endoscopic Versus Open Surgical Intervention for Congenital Laryngeal Webs: A Systematic Review and Meta-Analysis
Creators: Abigail E. Moore - University of Iowa, Orthopedics and Rehabilitation
Austin Walker - University of Iowa Hospitals and Clinics
Sohit Paul Kanotra - University of Iowa, Stead Family Department of Pediatrics
Resource Type: Journal article
Publication Details: Otolaryngology-head and neck surgery, Vol.169(2), pp.227-233
DOI: 10.1002/ohn.279
PMID: 36939597
NLM abbreviation: Otolaryngol Head Neck Surg
ISSN: 0194-5998
eISSN: 1097-6817
Publisher: Wiley
Number of pages: 7
Language: English
Date published: 08/01/2023
Academic Unit: Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
Record Identifier: 9984472858502771

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