Early surgical intervention in type I laryngeal cleft

Int J Pediatr Otorhinolaryngol. 2016 Nov:90:236-240. doi: 10.1016/j.ijporl.2016.09.017. Epub 2016 Sep 14.

Abstract

Objective: Diagnosis and treatment of type 1 laryngeal clefts remains a challenge. The purpose of this study is to determine if early surgical intervention in type I laryngeal clefts improves outcomes.

Methods: A retrospective case series was conducted at an academic tertiary care children's hospital. 18 children undergoing early (≤3 months from diagnosis) surgical intervention for type I laryngeal cleft repair between August of 2012 and December 2014. Data was compiled through a manual chart review.

Results: 18 children who underwent early surgical intervention for type I laryngeal cleft repair were identified for review. 14 (78%) were male and 4 (22%) were female and the average age at time of repair was 1.6 years. Most frequent presenting symptoms included dysphagia (61%) and recurrent respiratory issues (22%). Successful swallowing outcomes, defined as subjective improvement (i.e. absence of previous symptoms) per parental report in follow-up visits, +/- normal post-operative MBS (modified barium swallow) findings, was seen in 11 patients (61%). 9 patients required hospitalization for respiratory issues prior to surgical repair. Post-operatively, 4 patients still incurred an admission for respiratory reasons.

Conclusions: Our series shows a success rate of 61% with early surgical intervention (≤3 months from diagnosis). A decrease in post-operative hospitalizations is appreciated.

Keywords: Early surgical intervention; Endoscopic repair; Laryngeal cleft; Type I laryngeal cleft.

MeSH terms

  • Barium Sulfate
  • Congenital Abnormalities / diagnostic imaging
  • Congenital Abnormalities / surgery*
  • Contrast Media
  • Deglutition
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / etiology
  • Deglutition Disorders / surgery
  • Early Medical Intervention
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Laryngoscopy / methods*
  • Larynx / abnormalities*
  • Larynx / diagnostic imaging
  • Larynx / surgery
  • Male
  • Postoperative Period
  • Radiography
  • Retrospective Studies

Substances

  • Contrast Media
  • Barium Sulfate

Supplementary concepts

  • Laryngeal cleft