[Laryngo-tracheo-esophageal cleft associated with missed atresia]

Laryngo-tracheo-esophageal cleft (LTEC) is a rare malformation. Treatment is always surgical and still has uncertain results. One case of LTEC (type III), associated with a "missed atresia" of the esophagus is reported. The diagnosis of eso-tracheal, H-Type fistula was first suspected at birth before transfer of the baby to the neonatal surgery department where the diagnostic of long LTEC was established. Surgical repair was done through lateral cervicotomy and allowed complete cure of the eso-tracheal communication without tracheotomy. Barium swallowing, controlled on the eleventh post-operative day, showed a perfect result of the reconstruction and an underlying esophageal malformation, previously described as "missed atresia". The treatment of this second malformation was performed two months later by plain resection-anastomosis with excellent outcome at a one year follow up with no recurrent fistula nor GE reflux or laryngeal nerve palsy. To the best of our knowledge, this type of association has not been previously reported.