Journal article
Endoscopic repair of laryngotracheoesophageal clefts: experience in 17 cases.
- Leishman C Clinic of Otorhinolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Electronic address: crispinleishman@gmail.com.
- Monnier P Clinic of Otorhinolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
- Jaquet Y Clinic of Otorhinolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
- 2013-12-17
Published in:
- International journal of pediatric otorhinolaryngology. - 2014
Airway
Cleft
Endoscopy
Larynx
Repair
Surgery
Child
Child, Preschool
Congenital Abnormalities
Endoscopy
Female
Humans
Infant
Infant, Newborn
Larynx
Male
Retrospective Studies
Trachea
Treatment Outcome
English
OBJECTIVE
To review the presentation and evaluation of laryngotracheoesophageal clefts as well as their treatment modalities, especially endoscopic closure.
STUDY DESIGN
retrospective case series.
METHODS
All patients treated for laryngotracheoesophageal clefts in our clinic during the last 15 years were included. Analysis of preoperative data, surgical success and functional outcome was performed.
RESULTS
A total of 18 patients were included in our study. Cleft distribution was: type I (n=1), type II (n=3), type IIIa (n=5), type IIIb (n=8) and type IVa (n=1). All clefts were closed endoscopically by CO2 laser repair except for two patients who benfited from open surgery (one type I, one type IIIb). 7 of our 18 patients (39%) experienced a complication necessitating reoperation. Surgical treatment of LTEC allowed cessation of feeding tube assistance and artificial ventilation in 47% and 42% of patients respectively.
CONCLUSION
Surgical treatement of laryngotracheoesophageal clefts remains a complex procedure with a high rate of morbidity for high grade clefts. Post-surgical difficulties in feeding and breathing are associated with concomitant congenital anomalies. Endoscopic repair is a successful technique for treating up to grade IIIa laryngeal clefts. Further investigation is needed to assess the best approach for treating longer clefts.
To review the presentation and evaluation of laryngotracheoesophageal clefts as well as their treatment modalities, especially endoscopic closure.
STUDY DESIGN
retrospective case series.
METHODS
All patients treated for laryngotracheoesophageal clefts in our clinic during the last 15 years were included. Analysis of preoperative data, surgical success and functional outcome was performed.
RESULTS
A total of 18 patients were included in our study. Cleft distribution was: type I (n=1), type II (n=3), type IIIa (n=5), type IIIb (n=8) and type IVa (n=1). All clefts were closed endoscopically by CO2 laser repair except for two patients who benfited from open surgery (one type I, one type IIIb). 7 of our 18 patients (39%) experienced a complication necessitating reoperation. Surgical treatment of LTEC allowed cessation of feeding tube assistance and artificial ventilation in 47% and 42% of patients respectively.
CONCLUSION
Surgical treatement of laryngotracheoesophageal clefts remains a complex procedure with a high rate of morbidity for high grade clefts. Post-surgical difficulties in feeding and breathing are associated with concomitant congenital anomalies. Endoscopic repair is a successful technique for treating up to grade IIIa laryngeal clefts. Further investigation is needed to assess the best approach for treating longer clefts.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.ijporl.2013.10.068
- PMID 24332198
- Persistent URL
- https://sonar.ch/global/documents/248214
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