What Is Laryngeal Web?
Laryngeal web is a rare condition where the windpipe is partially constricted, or narrowed, making it difficult to breathe normally. The larynx (voice box) contains web-like tissue that reduces the amount of air flowing in and out of the windpipe. The web may be very thin or thick, which will determine how much the breathing is affected and may also impact the treatment method.
Causes
Laryngeal web is often a congenital defect, which means it is present from birth. In some cases, laryngeal webs can form later, often after long-term intubation.
Signs and Symptoms
The most common symptom is frequent shortness of breath and stridor, which includes a vibrating sound as if something is partially blocking the windpipe. Poor feeding and weak cry have been associated with these webs.
Other symptoms that may occur include:
- Wheezing
- Coughing
- Frequent chest infections
Some children also tend to raise their head or stretch their neck to open the airway as much as possible.
Diagnosis
Laryngeal web often has symptoms that can look like asthma, and it can be initially misdiagnosed.
When asthma medications or other treatments do not improve your child’s condition (often called refractory asthma), it is important to inform your doctor.
To properly diagnose tracheal web, the following diagnostic procedures may be used:
- Microlaryngoscopy: A microlaryngoscopy, or microscopic laryngoscopy, uses a small, flexible telescope to look in the airway for signs of a tracheal web or partial blockage.
- CT scan: In some cases, a picture of the chest may be needed to look for airway abnormalities.
Treatment
The goal of treatment is to remove the blockage by breaking the web, allowing the airway to open up to its full size. Depending on the severity of the web, the surgeon may do this by dilating (widening) the trachea and using a laser or cutting instrument to break the web. In some cases of a thicker web, the surgeon may recommend an open surgical approach to expand the airway.
Dilation
A small balloon is placed in the airway to widen or break the web. This may need to be repeated to prevent the web from coming back because of scar tissue.
Surgery
For some webs, the correct treatment is an open surgical procedure called a larynogofissure, opening into the larynx, generally through a midline cut through the neck.
Recovery
If dilation is needed, your child will spend one to two nights in the hospital until their breathing is safe. If an open neck procedure is needed, then one to two weeks is usually needed in the hospital following the operation.
Long-Term Outlook
Prognosis is good with a normal life span. The only noticeable long-term symptoms may be a hoarse or rough voice.
Call Your Doctor If:
Your child experiences:
- Excessive shortness of breath during exercise or at rest
- Frequent chest infections
- Continued noisy breathing
