Congenital laryngeal defects in the adult

Two types of congenital laryngeal defects in the adult are presented. The first case is a patient with a laryngeal cleft who became symptomatic at 42 years of age. Dysphagia, dyspnea, hoarseness and aspiration progressed in severity until surgery was necessary at the age of 48 years. The second case presented is a 21-year-old male with nonfusion of the thyroid laminae. He was asymptomatic except for persistence of a high-pitched voice after puberty. The case histories and radiographic studies are reviewed, emphasizing that the diagnosis of these defects was more difficult than their management. The surgical repair is described and illustrated. Briefly, this involved repair of the laryngeal cleft using techniques similar to those of a hernoiorrhaphy. The nonfusion of the thyroid laminae and resultant defective anterior glottis was repaired using bipedicled muscle flaps and a silicone keel.