Complete laryngotracheoesophageal cleft: management and repair

A newborn baby with a complete or type III laryngotracheoesophageal cleft from larynx to carina was managed with a bifurcated endobronchial tube prior to complete reconstruction in one stage. To prevent pressure on the posterior suture line, a tracheostomy tube was constructed from a REA tube originally designed to use for cleft palate repairs. Fundoplication prevented gastroesophageal reflux and allowed enteral feedings. The child is now monitored at home on a prolonged pharyngeal retraining program with intermittent plugging of his tracheostomy tube. This report describes the management and repair of the first long-term survivor with this severe defect.