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Endoscopic Repair of Laryngeal Clefts: 8 Years’ Experience

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

To emphasize the need for high clinical suspicion in the diagnosis of Laryngeal cleft in paediatric population, to catalogue the pattern of presentation, time to treatment and the evolution of surgical techniques for Laryngeal cleft repair at our center. A retrospective review of laryngeal cleft cases which presented over a period of 8 years (May 2012–May 2020), from a tertiary care center, was done. Data includes—patient demographics, preliminary investigations, diagnostic methods, type of cleft, surgical steps and post-operative follow up. Extensive literature search was done and we could not find similar studies from South East Asia and the Indian subcontinents. Of the 10 patients 7 were managed surgically and 3 conservatively. There was an equal distribution of type 1 (n = 5) and 2 (n = 5) clefts. 80% cases were males and 9 out of 10 patients had associated congenital anomalies. 80% cases had symptom resolution (75% were managed surgically and 25% managed medically). Surgical intervention should be based on the extent of anatomical defect and the functional impairment caused by cleft such as respiratory problems, persistence of feeding issues despite maximal medical management and feeding therapy. Early surgical management of type I and II clefts have satisfactory outcomes.

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Abbreviations

LC:

Laryngeal cleft

FEES:

Fiber-optic endoscopic evaluation of swallowing

TE:

Tracheo esophageal

TEF:

Tracheaesophageal fistula

MBS:

Modified barium swallow

DL:

Direct laryngoscopy

GA:

General anesthesia

OGT:

Orogastric tube

LRTI:

Lower respiratory tract infection

yrs:

Years

IA:

Inter arytenoid

pre op:

Preoperative

post op:

Post operative

CXR:

Chest X ray

ETT:

Endotracheal tube

PDS:

Polydioxanone suture

POD:

Postoperative day

TORS:

Trans oral robotic surgery

fig:

Figure

PICU:

Paediatric intensive care unit

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, Children’s Airway and Swallowing Centre, Manipal Hospitals, 98, HAL Airport Road, Bengaluru, India

    Ria Emmanuel, Eswaran V Raman & Deepa Shivnani

Authors
  1. Ria Emmanuel
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  2. Eswaran V Raman
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  3. Deepa Shivnani
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RE, EVR and DS. The first draft of the manuscript was written by RE and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ria Emmanuel.

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Emmanuel, R., Raman, E.V. & Shivnani, D. Endoscopic Repair of Laryngeal Clefts: 8 Years’ Experience. Indian J Otolaryngol Head Neck Surg 74, 296–304 (2022). https://doi.org/10.1007/s12070-021-02479-y

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  • DOI: https://doi.org/10.1007/s12070-021-02479-y

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