PHẪU THUẬT ĐẶT KEEL THANH QUẢN TRONG ĐIỀU TRỊ DÍNH MÉP TRƯỚC DÂY THANH

Abstract

Background: Anterior glottic web may be congenital or acquired. The size of the web ranges from minimal adhesions to complete involvement of the membranous vocal folds, resulting in substantial variation in clinical presentation and treatment options. Management is challenging due to a high risk of recurrence and significant impact on voice quality. The therapeutic goal is to restore both phonatory and airway functions. Materials and Methods: A descriptive interventional case series was conducted on 14 patients diagnosed with anterior glottic web and treated at the Department of Otorhinolaryngology, Cho Ray Hospital, from 2013 to 2025. Results: Among the 14 cases, two were congenital, and trauma was the most common etiology (6/14). According to Cohen’s classification, there were eight cases of grade I, four cases of grade II, and two cases of grade III–IV webs. Keel placement was performed via open-neck surgery in 12 patients and endoscopically in two. VHI scores showed significant postoperative improvement. At the 3-month follow-up, one patient had persistent mild adhesion (Cohen grade I). Overall outcomes included 71.4% good, 28.6% moderate, and no poor results. Conclusion: Laryngeal keel placement is a safe and feasible method for the management of anterior glottic web, contributing to improved voice quality, prevention of re-adhesion, and restoration of glottic function.