Premium
Complete Laryngotracheoesophageal Cleft: Complicated Management Issues
Author(s) -
Chitkara Ajay E.,
Tadros Monica,
Kim H. Jeffrey,
Harley Earl H.
Publication year - 2003
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200308000-00010
Subject(s) - medicine , surgery , tracheoesophageal fistula , asymptomatic , airway , intensive care medicine , esophagus
Objectives/Hypothesis Laryngotracheoesophageal clefts are rare developmental anomalies of the upper aerodigestive tract. They range in severity from being virtually asymptomatic throughout life (type I) to being incompatible with life (type IV). The timing of diagnosis is crucial to the successful treatment of severe clefts. Treatment is complicated and requires a multiteam approach. The case report discusses the elements involved in diagnosing and treating this severe airway anomaly. Study Design Case report. Methods Review of a case at a tertiary care center. Results A case of a complete laryngotracheoesophageal cleft with left‐side pulmonary agenesis in a newborn is reported. Rigid bronchoscopy revealed a common tracheoesophageal lumen from the larynx to the stomach with a single bronchus supplying the right‐side lung. Management of this patient included establishment and maintenance of a tenuous airway, maintenance of nutrition, and anesthetic and surgical planning for upper aerodigestive tract reconstruction. Conclusions Although severe laryngotracheoesophageal clefts are rare, they require prompt, team‐oriented management for the best outcome possible. The diagnosis, sustenance, and treatment options of these patients depend on varied and complicated factors, which are discussed.