Background: Endoscopic keel placement is difficult for patients with poor laryngeal exposures.
Aims/objectives: To introduce a novel extra-endo laryngeal puncture technique for endoscopic keel placement to manage anterior glottic webs.
Material and methods: Patients with anterior glottic webs and difficult laryngeal exposure in our hospital during 2018 to 2020 were recruited in this study. After the incision of the web, a novel puncture needle modified from a maxillary sinus puncture needle was inserted into endolarynx, and could pull the suture passing along a keel from inside out. The suture was then fixated on the neck, and the keel was placed for 4 weeks. Patients were followed up for at least 1 year.
Results: Eight patients including three men and five women were included in this study. All the patients tolerated the silicone keel well, and 7 of 8 (87.5%) patients did not have web relapses and reached remarkable voice improvements during follow-up. None of the cases needed a tracheotomy due to the dyspnea postoperatively.
Conclusions and significance: The novel puncture technique is an easy and effective approach to facilitate endoscopic keel placement for the treatment of anterior glottic webs and other surgical procedures requiring endolaryngeal suturing.
Keywords: Anterior glottic web; endoscopic keel placement; puncture needle; silicone stent.