Pulmonary and Radiographic Findings in Pediatric Type 1 Laryngeal Cleft.

Area of Science:

• Pediatric Pulmonology
• Otolaryngology
• Congenital Malformations

Background:

• Laryngeal clefts are congenital anomalies that can lead to chronic microaspiration and lung disease.
• Type 1 laryngeal clefts present subtly, making treatment decisions controversial.
• Pulmonary complications necessitate evaluation and management strategies.

Purpose of the Study:

• To describe pulmonary symptoms and radiographic findings in children with type 1 laryngeal clefts.
• To evaluate the impact of endoscopic CO2-laser repair on these findings.
• To inform clinical decision-making regarding surgical intervention.

Main Methods:

• Retrospective cohort study of pediatric patients undergoing type 1 laryngeal cleft repair (August 2003 - August 2022).
• Chart review including respiratory history, symptoms, medications, and pre/post-repair chest X-rays (CXRs).
• Comparison of CXR findings before and after endoscopic CO2-laser repair.

Main Results:

• 325 pediatric patients (median age 2.6 years) underwent repair.
• 99% presented with respiratory symptoms; 44% had prior pneumonia.
• Post-repair CXRs showed significant reduction in atelectasis and bronchial wall thickening.

Conclusions:

• Pulmonary symptoms and abnormal chest X-rays are frequent in type 1 laryngeal clefts.
• Endoscopic repair is associated with improved radiographic findings.
• Consider endoscopic repair for patients unresponsive to medical management.