Diagnosis and management of type 1 laryngeal cleft

Posterior laryngeal clefts have been reported as exceptionally rare congenital anomalies. We demonstrate that type 1 posterior laryngeal clefts are more common than previously described, by reporting a series of 12 type 1 posterior laryngeal clefts diagnosed at our institution over a 12-month period. Typically, type 1 posterior laryngeal clefts are managed conservatively. In our series, 75% of the clefts were treated successfully with endoscopic repair, following failure of conservative management. This suggests surgical repair may be warranted in a greater number of type 1 posterior laryngeal clefts in an attempt to prevent associated morbidity, secondary to aspiration, pneumonia and respiratory distress. We highlight the importance of educating other paediatric specialities in maintaining a high index of suspicion for the presence of a posterior laryngeal cleft when treating patients with suggestive symptoms. This leads to early referral and diagnosis.