title: Laryngeal cleft: evaluation and management.
abstract: OBJECTIVE
  Review the latest diagnostic and treatment modalities for laryngeal and laryngotracheoesophageal clefts as they can be a major cause of respiratory and feeding morbidity in the infant and pediatric population.
  
  
  METHODS
  Literature review of published reports.
  
  
  RESULTS
  The presentation of laryngeal cleft usually involves respiratory symptoms, such as stridor, chronic cough, aspiration, and recurrent respiratory infections. Clefts of the larynx and trachea/esophagus can occur in isolation, as part of a syndrome (Opitz-Frias, VATER/VACTERL, Pallister Hall, CHARGE), or with other associated malformations (gastrointestinal, genitourinary, cardiac, craniofacial). This publication reviews the presenting signs/symptoms, diagnostic options, prognosis, and treatment considerations based on over a decade of experience of the senior author with laryngeal clefts.
  
  
  CONCLUSIONS
  Type I laryngeal clefts can be managed medically or surgically depending on the degree of morbidity. Types II, III, and IV require endoscopic or open surgery to avoid chronic respiratory and feeding complications.
authors.affiliation: Division of Otolaryngology, Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE, United States. Electronic address: douglas.johnston@nemours.org.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Johnston
authors.affiliation: Department of Pediatric Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, United States; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, United States.
authors.forename: Karen
authors.initials: K
authors.lastname: Watters
authors.affiliation: Department of Anesthesiology, Boston Children's Hospital, Boston, MA, United States.
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Ferrari
authors.affiliation: Department of Pediatric Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, United States; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, United States.
authors.forename: Reza
authors.initials: R
authors.lastname: Rahbar
mesh_terms: D002648:Child; D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000628:therapy; D004724:Endoscopy; D004947:Esophagus / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D007223:Infant; D007830:Larynx / Q000002:abnormalities* / Q000601:surgery; D014132:Trachea / Q000002:abnormalities* / Q000601:surgery
keywords: Aspiration; Cough; Laryngeal cleft; Laryngotracheoesophageal cleft; Stridor