Congenital web is a medical condition in which the child's trachea (windpipe) is obstructed due to formation of a layer of web-like tissue, which results in breathing difficulties and other symptoms.
Incomplete canalization of the laryngeal lumen.
It is congenital, i.e it presents since birth, but is could be acquired in some cases.
- Commonest site is glottic, may extend to subglottis.
- May be small, large, or imperforate fibrous ring.
- Small web: asymptomatic, hoarse cry, mild stridor.
- Large web: weak hoarse cry, evident stridor.
- Imperforate web: Cyanosis with no cry usually fatal.
- Flexible or direct laryngoscopy: symmetrical grayish white membrane may be a semi translucent triangular band, or thick membrane.
Treatment of Congenital web:
A. Mild if no symptoms ………… no treatment.
- Tracheostomy if severe obstruction.
- Excision of web by:
- Microlaryngosurgery (MLS) using laser or cold instrument.
- Laryngofissure in very thick web
C: Imperforate web: Urgent tracheostomy or rigid bronchoscope to rupture the web.