A congenital glottic web (CGW) is a rare congenital disorder of the larynx that may vary in its severity.
Pathogenesis: failure of recanalization of larynx during embryonic development
Classification of Cohen
|
Percent of Glottis Involved
|
Subglottic Involvement
|
Vocal Cords
|
Type
|
|
< 35%
|
none or little
|
visible
|
1
|
|
35 to 50%
|
thin anterior web; minimal subglottic involvement
|
visible
|
2
|
|
50 to 75%
|
thin or thick web that extends for lower border of cricoid
|
fused anteriorly; thin out posteriorly
|
3
|
|
> 75%
|
thick web that extends to lower cricoid
|
none; complete fusion
|
4
|
|
Type
|
Symptoms
|
|
1
|
none or mild hoarseness
|
|
2
|
cry weak or hoarse; airway compromise with exertion
|
|
3
|
marked vocal dysfunction' voice weak and whispery; moderate airway obstruction
|
|
4
|
severe airway obstruction; aphonic; needs tracheostomy
|
Complications:
(1) negative pressure pulmonary edema with heart failure
(2) recurrent lower respiratory tract infection
(3) respiratory distress
Differential diagnosis:
(1) congenital subglottic stenosis/atresia
(2) acquired laryngotracheal stenosis
