Current management of laryngeal and laryngotracheoesophageal clefts.
Laryngeal and laryngotracheoesophageal clefts (L-LTEC) are uncommon anomalies in neonates that cause significant morbidity secondary to aspiration, pneumonia, and respiratory distress. Other anomalies of development, such as esophageal atresia and tracheoesophageal fistula (EA-TEF), are observed in 20% of patients with L-LTEC and often confuse the radiographic and clinical picture. Repair of L-LTEC depends on the length and location of the cleft, associated anomalies, and concurrent systemic illness. For type I L-LTEC, endoscopic repair occasionally is possible with microsurgical instrumentation. With types II to IV L-LTEC, an open approach must be used. Tracheotomy is a universal requirement, often for extended periods of time. Reported here is our experience with four cases of L-LTEC managed over the past 7 years at Texas Children's Hospital.
DuBois
J J
JJ
Department of Surgery, Baylor College of Medicine, Houston, TX 77030.
Pokorny
W J
WJ
Harberg
F J
FJ
Smith
R J
RJ
D004724:Endoscopy; D004933:Esophageal Atresia / Q000150:complications; D004947:Esophagus / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007830:Larynx / Q000002:abnormalities* / Q000601:surgery; D008297:Male; D011015:Pneumonia, Aspiration / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology; D014132:Trachea / Q000002:abnormalities* / Q000601:surgery; D014138:Tracheoesophageal Fistula / Q000150:complications; D014140:Tracheotomy