title: Type IV laryngotracheoesophageal clefts: surgical management for long-term survival.
abstract: Complete laryngotracheoesophageal clefts (types III and IV) are rare congenital anomalies that occur when the primitive foregut fails to separate into the tracheobronchial tree and the esophagus. This article summarizes a 10-year institutional experience with six infants who had type IV clefts, presents a modification of the authors' surgical approach, and identifies pitfalls in the management of these infants. Three of the six children are long-term survivors. The recognition of specific complicating issues leads to a standardized approach, which can result in successful repair and long-term survival.
authors.affiliation: Department of Pediatric Surgery, Massachusetts General Hospital, Boston 02114, USA.
authors.forename: B B
authors.initials: BB
authors.lastname: Simpson
authors.forename: D P
authors.initials: DP
authors.lastname: Ryan
authors.forename: P K
authors.initials: PK
authors.lastname: Donahoe
authors.forename: J J
authors.initials: JJ
authors.lastname: Schnitzer
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.forename: D P
authors.initials: DP
authors.lastname: Doody
mesh_terms: D000015:Abnormalities, Multiple / Q000145:classification / Q000000981:diagnostic imaging / Q000196:embryology / Q000601:surgery*; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D004947:Esophagus / Q000002:abnormalities*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007830:Larynx / Q000002:abnormalities*; D008297:Male; D011859:Radiography; D013270:Stomach / Q000002:abnormalities; D016019:Survival Analysis; D014132:Trachea / Q000002:abnormalities*; D016896:Treatment Outcome