Type I laryngeal cleft: late presentation

Area of Science:

• Pediatric Pulmonology
• Congenital Airway Malformations
• Gastroenterology

Background:

• Laryngeal cleft anomalies are rare congenital defects affecting the posterior laryngotracheal wall.
• Typically, these anomalies present in the neonatal period with recurrent respiratory infections.
• Type I clefts, in particular, can have subtle presentations leading to delayed diagnosis.

Observation:

• A case of a type I laryngeal cleft is presented in a 19-year-old patient.
• The patient exhibited a history of recurrent lower respiratory tract infections.
• Severe gastro-oesophageal reflux disease was also a significant comorbidity.

Findings:

• This represents the oldest documented initial presentation of a congenital laryngeal cleft.
• The findings underscore that laryngeal clefts may not present until early adulthood.
• Gastro-oesophageal reflux disease appears to play a crucial role in the manifestation of laryngeal clefts.

Implications:

• Clinicians should maintain a high index of suspicion for laryngeal clefts, even in young adults.
• Late diagnosis of laryngeal clefts can occur, necessitating continued vigilance.
• Understanding the link between gastro-oesophageal reflux disease and laryngeal clefts is vital for accurate diagnosis and management.