title: The utility of the fiberoptic endoscopic evaluation of swallowing (FEES) in diagnosing and treating children with Type I laryngeal clefts.
abstract: This case series of three young children with type I laryngeal clefts is presented to demonstrate the utility of fiberoptic endoscopic evaluation of swallowing (FEES) in managing these patients. FEES revealed laryngeal penetration in a posterior to anterior direction in two patients and penetration from lateral to medial in the third patient. The type of laryngeal penetration helped in making the diagnosis of a type I cleft in two children and helped establish a safe feeding regiment in the third child. Patients with type I laryngeal clefts are often misdiagnosed, most likely resulting from the complex presentation of signs/symptoms and the difficulty of detecting small clefts with currently available tests. The pattern of laryngeal aspiration seen with FEES can help in diagnosis and management in this patient population.
authors.affiliation: Massachusetts Eye and Ear Infirmary, Department of Otolaryngology, Boston, 02114-3914, USA. M.Boseley@att.net
authors.forename: Mark E
authors.initials: ME
authors.lastname: Boseley
authors.forename: Jean
authors.initials: J
authors.lastname: Ashland
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hartnick
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007223:Infant; D007818:Laryngeal Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000002:abnormalities* / Q000196:embryology / Q000473:pathology; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures; D016896:Treatment Outcome