title: Outcomes and predictors of surgical management in type 1 laryngeal cleft swallowing dysfunction.
abstract: To examine the effect of and predict the success of type 1 laryngeal cleft (LC-1) augmentation through swallowing evaluations.
  
  
  
  Retrospective chart analysis.
  
  
  
  Sixty-eight patients with LC-1s underwent interarytenoid injection laryngoplasty (IL) and were examined. The median age at IL was 9 months. Swallowing evaluations were performed pre- and postoperatively using fiberoptic endoscopic examination of swallowing or modified barium swallow. The presence of aspiration or penetrations at various consistencies was recorded. McNemar's tests were used to detect changes in swallowing pre- and postoperatively. Logistic regression was used to assess factors affecting the odds of postoperative success.
  
  
  
  Preoperatively, 89.7% of patients demonstrated penetration or aspiration. Post-IL, 69.1% were safe for thins, and 75% showed improvement in swallowing. Postoperatively, there was a significant reduction in patients experiencing problems with thin liquids (P < 0.001) and in those with frank or silent aspiration (P < 0.001). Patients with penetrations on thin liquids had higher likelihood of a successful IL (odds ratio [OR] = 3.68, P = 0.021). The probability of success with silent aspiration at any consistency was significantly decreased (OR = 0.26, P = 0.015). Fifteen patients underwent formal endoscopic surgical repair, and 90.0% were safe with thin consistencies postoperatively.
  
  
  
  A large proportion of patients with LC-1 and associated swallowing dysfunctions respond favorably to IL and formal repair. Children who demonstrated penetration with thin liquids had a higher rate of swallowing dysfunction resolution post-IL; whereas patients demonstrating silent aspiration had poorer responses to IL.
  
  
  
  4. Laryngoscope, 126:2838-2843, 2016.
authors.affiliation: Department of Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.|Department of Pediatric Otolaryngology, Children's Hospital of Michigan, Detroit, Michigan, U.S.A.|Department of Pediatric Otolaryngology, Michigan Pediatric Ear, Nose & Throat Associates, West Bloomfield, Michigan, U.S.A.|Department of Pediatric Otolaryngology, Beaumont Children's Hospital, Royal Oak, Michigan, U.S.A.
authors.forename: Prasad John
authors.initials: PJ
authors.lastname: Thottam
authors.affiliation: Department of Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Matthew
authors.initials: M
authors.lastname: Georg
authors.affiliation: Department of Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: David
authors.initials: D
authors.lastname: Chi
authors.affiliation: Department of Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.|Department of Pediatric Otolaryngology, Texas Children's Hospital, Houston, Texas, U.S.A.
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Mehta
mesh_terms: D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000601:surgery*; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D057286:Electronic Health Records; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007267:Injections; D007817:Laryngeal Cartilages; D058753:Laryngoplasty / Q000379:methods*; D007828:Laryngoscopy; D007830:Larynx / Q000002:abnormalities* / Q000601:surgery; D008297:Male; D053120:Respiratory Aspiration / Q000209:etiology; D012189:Retrospective Studies
keywords: Airway; aspiration; fiberoptic endoscopic evaluation of swallowing; injection laryngoplasty; laryngeal cleft; modified barium swallowing; pediatrics; penetration; swallowing