Laryngeal cleft

A high proportion of babies born with OA/TOF also have laryngeal clefts, with a prevalence of 8.3% to 19.6%. (7,93,98) A further 8.3% have oropharyngeal anomalies. Both of these add to dysphagia and aspiration and are often underdiagnosed in patients with OA/TOF compared to their non-TOF counterparts, due to these symptoms already existing due to this anomaly. Whilst many are picked up in childhood, some are not detected until worsening aspiration and dysphagia symptoms in adulthood. (7) Secretions can ‘pool’ in the cleft and tip over into the airways, often when lying down.

Symptoms

  • Known history of OA/TOF
  • Recurrent wheeze
  • Recurrent aspiration
  • Dysphagia
  • Aspiration pneumonia

Diagnosis

This is diagnosed by endoscopy, laryngoscopy and bronchoscopy under general anaesthetic.

Treatment

This is usually repaired surgically.

References