Laryngotracheo-oesophageal cleft. A report of three cases

The clinical presentation of cleft larynx is described in a mother, and her first-born child, and in a third, unrelated child. The symptoms vary with the anatomical severity of the cleft, but may closely resemble those of H-type tracheo-oesophageal fistula. Modifications to Pettersson's classification of the condition are suggested. These allow more precise definition of the milder cases in which surgery carries a reasonable prognosis. The accuracy of clinical diagnosis, especially at laryngoscopy, has been disappointing. The importance of probing the posterior wall of the larynx at direct laryngoscopy is emphasised, since the larynx may appear normal even when an extensive cleft is present.