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Cleft larynx. A report of seven cases
The Annals of Otology, Rhinology, and Laryngology
|November 1, 1975
Summary
This study details posterior cleft larynx and laryngotracheoesophageal clefts, rare congenital anomalies. Early endoscopic diagnosis and appropriate management, medical or surgical, improve patient outcomes for these airway defects.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Diagnostics
Background:
- Congenital laryngeal clefts are rare anomalies that can be difficult to diagnose.
- This paper aims to increase awareness and improve management of posterior cleft larynx and laryngotracheoesophageal clefts.
Observation:
- Seven cases are presented: four with limited cricoid lamina defects (posterior cleft larynx) and three with extensive laryngotracheoesophageal clefts.
- Posterior cleft larynx, limited to the cricoid lamina, is diagnosed via endoscopy and managed medically with gastrostomy feeding and tracheotomy only for aspiration.
- Extensive laryngotracheoesophageal clefts require surgical repair, potentially involving thoracic approaches for intrathoracic extension.
Findings:
- Posterior cleft larynx is characterized by arytenoid malposition due to interarytenoidius muscle deficiency, leading to aspiration.
- The study adds seven cases to the ~30 reported worldwide, highlighting the under-recognized incidence of cleft larynx, especially with tracheoesophageal fistulae.
Implications:
- Endoscopic diagnosis is crucial for limited cricoid lamina defects.
- Aspiration in patients with repaired atresia warrants investigation for associated cleft larynx before assuming stricture or fistula recurrence.
- Distinguishing between posterior cleft larynx and laryngotracheoesophageal cleft is essential for appropriate treatment strategies.