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Management of laryngeal cleft in mechanically ventilated children with severe comorbidities

Rumi Ueha1, Takao Goto1, Asako Kaneoka2

  • 1Department of Otolaryngology, The University of Tokyo, Tokyo, Japan.

Auris, Nasus, Larynx
|April 21, 2018
PubMed

Insights

Laryngeal clefts, rare congenital larynx malformations, present with varied severity and symptoms like dysphagia. Treatment for affected children with comorbidities depends on individual conditions and cleft type.

Area of Science:

  • Pediatric Surgery
  • Otolaryngology
  • Congenital Malformations

Background:

  • Laryngeal clefts are rare congenital posterior larynx malformations.
  • Severity correlates with downward extension, causing dysphagia and respiratory distress.
  • Comorbidities significantly influence treatment strategies.

Observation:

  • Two cases of pediatric laryngeal clefts with severe comorbidities requiring mechanical ventilation are presented.
  • One patient had a type III cleft managed successfully via lateral pharyngotomy.
  • Another patient with a type II cleft, too unstable for surgery, underwent feeding and swallowing therapy.

Findings:

  • Successful surgical management of type III laryngeal cleft via lateral pharyngotomy in a patient with comorbidities.
  • Non-surgical management including feeding and swallowing therapy for a type II laryngeal cleft in a patient with severe comorbidities unsuitable for surgery.

Implications:

  • Demonstrates the efficacy of lateral pharyngotomy for specific laryngeal cleft types in complex pediatric cases.
  • Highlights the importance of tailored, condition-dependent management for pediatric laryngeal clefts.
  • Emphasizes the need for alternative therapies like feeding and swallowing training when surgical intervention is contraindicated.

Keywords:
Laryngeal cleftLateral pharyngotomyMechanical ventilationSevere comorbiditySwallowing management

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