title: Outcomes and Resource Utilization of Endoscopic Mass-Closure Technique for Laryngeal Clefts.
abstract: OBJECTIVE
  To compare resource utilization and clinical outcomes between endoscopic mass-closure and open techniques for laryngeal cleft repair.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary academic children's hospital.
  
  
  METHODS
  Pediatric patients undergoing repair for Benjamin-Inglis type 1-3 laryngeal clefts over a 15-year period. All 20 patients undergoing endoscopic repair were included. Eight control patients undergoing open repair were selected using matching by age and cleft type. Demographic, clinical, and resource utilization data were collected.
  
  
  RESULTS
  Twenty-eight patients were included (20 endoscopic, 8 open). Mean age, rates of tracheostomy and vocal fold immobility, and distribution of cleft types were not different between the 2 groups (all P > .2). Mean operative time (P = .004) and duration of hospital stay (P < .001) were significantly shorter in the endoscopic group. All repairs were intact in both groups at final postoperative endoscopy. Rates of persistent laryngeal penetration or aspiration on swallow study were not different between groups (P = 1.000), although results were available for only 11 patients.
  
  
  CONCLUSIONS
  Endoscopic laryngeal cleft repair using a mass-closure technique provides a durable result while requiring significantly shorter operative times and hospital stays than open repair and avoiding the potential morbidity of laryngofissure. However, open repair may allow the simultaneous performance of other airway reconstructive procedures and may be a useful salvage technique when endoscopic repair fails. Postoperative swallowing results require further study.
authors.affiliation: Department of Otorhinolaryngology-Head & Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: Karthik
authors.initials: K
authors.lastname: Balakrishnan
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Loyola University School of Medicine, Chicago, Illinois, USA.
authors.forename: Esther
authors.initials: E
authors.lastname: Cheng
authors.affiliation: Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
authors.forename: Alessandro
authors.initials: A
authors.lastname: de Alarcon
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Sidell
authors.affiliation: Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
authors.forename: Catherine K
authors.initials: CK
authors.lastname: Hart
authors.affiliation: Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA mike.rutter@cchmc.org.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rutter
mesh_terms: D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000601:surgery*; D003422:Critical Care; D003679:Deglutition; D004724:Endoscopy; D005260:Female; D006801:Humans; D007223:Infant; D007830:Larynx / Q000002:abnormalities* / Q000601:surgery; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: endoscopic; laryngeal cleft; resource utilization