Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-29T18:24:15.991Z Has data issue: false hasContentIssue false
  • English
  • Français

Primary endoscopic repair of intermediate laryngeal clefts

Published online by Cambridge University Press:  07 January 2011

S J Broomfield ,
I A Bruce  and
M P Rothera
I A Bruce
Affiliation:
Department of Otolaryngology, Royal Manchester Children's Hospital, UK
M P Rothera
Affiliation:
Department of Otolaryngology, Royal Manchester Children's Hospital, UK
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Traditionally, small laryngeal clefts may be closed endoscopically, while larger clefts necessitate an open anterior approach. We report the presentation, evaluation and outcome following endoscopic surgical repair of a series of laryngeal clefts.

Method:

Retrospective study of children treated in a tertiary referral centre between 2003 and 2008. The presenting symptoms, patient demographics, cleft type, surgical outcome and complications were evaluated.

Results:

Seven children underwent primary endoscopic repair of their laryngeal clefts (four Benjamin-Inglis type III clefts and three type II clefts). Presenting symptoms included stridor, cough and cyanosis with feeds, swallowing problems, weak cry, and recurrent lower respiratory tract infection. Treatment was ultimately successful in six of the seven children; treatment was ongoing for the remaining child, who underwent subsequent revision surgery via an open approach. Two children went on to require a second endoscopic repair, and two underwent an open repair of a residual defect. One child required a tracheostomy for failed extubation in the post-operative period.

Conclusion:

Endoscopic repair is a safe, useful technique in the management of laryngeal clefts. Laryngeal clefts must be excluded in a child presenting with persistent aerodigestive tract symptoms, as described here.

Keywords

LarynxCongenital AbnormalitiesSurgeryEndoscopy
Type
Short Communication
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 5 , May 2011 , pp. 513 - 516
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the British Association of Paediatric Otolaryngology, 12 September 2008, Epsom, UK

References

1Bell, DW, Christiansen, TA, Smith, TE Jr, Stucker, FJ. Laryngotracheoesophageal cleft: the anterior approach. Ann Otol Rhinol Laryngol 1977;86:616–22CrossRefGoogle ScholarPubMed
2Roth, B, Rose, KG, Benz-Bohm, G, Gunther, H. Laryngotracheoesophageal cleft: clinical features, diagnosis and therapy. Eur J Pediatr 1983;140:41–6CrossRefGoogle Scholar
3Parsons, DS, Stivers, FE, Giovanetto, DR, Phillips, SE. Type I posterior laryngeal clefts. Laryngoscope 1998;108:403–10CrossRefGoogle ScholarPubMed
4Benjamin, B, Inglis, A. Minor congenital laryngeal clefts: diagnosis and classification. Ann Otol Rhinol Laryngol 1989;98:417–20CrossRefGoogle ScholarPubMed
5Koltai, PJ, Morgan, D, Evans, JN. Endoscopic repair of supraglottic laryngeal clefts. Arch Otolaryngol Head Neck Surg 1991;117:273–8CrossRefGoogle ScholarPubMed
6Kubba, H, Gibson, D, Bailey, M, Hartley, B. Techniques and outcomes of laryngeal cleft repair: an update to the Great Ormond Street Hospital series. Ann Otol Rhinol Laryngol 2005;114:309–13CrossRefGoogle Scholar
7Watters, K, Russell, J. Diagnosis and management of type I laryngeal cleft. Int J Pediatr Otorhinolaryngol 2003;67:591–6CrossRefGoogle Scholar
8Chien, W, Ashland, J, Haver, K, Hardy, SC, Curren, P, Hartnick, CJ. Type 1 laryngeal cleft: establishing a functional diagnostic and management algorithm. Int J Pediatr Otorhinolaryngol 2006;70:2073–9CrossRefGoogle ScholarPubMed
9Rahbar, R, Rouillon, I, Roger, G, Lin, A, Nuss, RC, Denoyelle, F et al. The presentation and management of laryngeal cleft: a 10-year experience. Arch Otolaryngol Head Neck Surg 2006;132:1335–41CrossRefGoogle Scholar
10Bent, JP, Bauman, N, Smith, RJH. Endoscopic repair of type 1A laryngeal clefts. Laryngoscope 1997;107:282–6CrossRefGoogle Scholar
11Sandu, K, Monnier, P. Endoscopic laryngotracheal cleft repair without tracheostomy or intubation. Laryngoscope 2006;116:630–4CrossRefGoogle ScholarPubMed