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Eur J Pediatr Surg 2012; 22(03): 260-263
DOI: 10.1055/s-0032-1308708
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Pharyngoesophagoplasty, Posterior Laryngotracheoplasty, and Esophagotracheoplasty for Type III Laryngotracheoesophageal Cleft with a Distal Tracheobronchoesophageal Cleft

Shilpa Sharma
1   Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Dr RML Hospital, New Delhi, India
,
Amita Sen
1   Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Dr RML Hospital, New Delhi, India
,
Arti Maria
2   Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Dr RML Hospital, New Delhi, India
,
Jaswinder Kaur
3   Department of Otolayngology, Post Graduate Institute of Medical Education and Research, Dr RML Hospital, New Delhi, India
,
Ashok Kumar
3   Department of Otolayngology, Post Graduate Institute of Medical Education and Research, Dr RML Hospital, New Delhi, India
,
Rakesh Garg
4   Department of Anaesthesia, Post Graduate Institute of Medical Education and Research, New Delhi, India
,
Ajay Goila
4   Department of Anaesthesia, Post Graduate Institute of Medical Education and Research, New Delhi, India
› Author Affiliations
Further Information

Publication History

17 November 2011

09 January 2012

Publication Date:
10 May 2012 (online)

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Introduction

Laryngotracheoesophageal cleft (LTEC) is a rare disorder allied with serious associated anomalies. Benjamin and Inglis classified laryngeal clefts as type 1: supraglottic interarytenoid cleft. Type II: partial cricoid cleft extending below the level of the vocal folds. Type III: total cricoid cleft that may extend to the cervical tracheoesophageal septum. Type IV: laryngoesophageal cleft involving a major part of the tracheoesophageal wall in the thorax.[1] Out of these, the types III and IV are most challenging to diagnose and manage being life-threatening conditions.

An unusual case of type III LTEC and distal tracheobronchoesophageal cleft with an intervening normal oesophageal segment without esophageal atresia that has not been reported is described. A novel staged surgical management adopted for this rare combination is discussed.

 

  • References

  • 1 Benjamin B, Inglis A. Minor congenital laryngeal clefts: diagnosis and classification. Ann Otol Rhinol Laryngol 1989; 98 (6) 417-420
    Search in Google Scholar
  • 2 Prabhu BV, Prakash B, Mohan M. A rare case of laryngotracheo-esophageal cleft with an extended broncho-esophageal cleft. Journal of Indian Association of Pediatric Surgeons 2004; 9 (2) 103-106
    PubMedSearch in Google Scholar
  • 3 Mathur NN, Peek GJ, Bailey CM, Elliott MJ. Strategies for managing Type IV laryngotracheoesophageal clefts at Great Ormond Street Hospital for Children. Int J Pediatr Otorhinolaryngol 2006; 70 (11) 1901-1910
    CrossrefPubMedSearch in Google Scholar
  • 4 Pinlong E, Lesage V, Robert M, Mercier C, Ployet MJ. Type III-IV laryngotracheoesophageal cleft: report of a successfully treated case. Int J Pediatr Otorhinolaryngol 1996; 36 (3) 253-262
    Search in Google Scholar
  • 5 Rahbar R, Rouillon I, Roger G , et al. The presentation and management of laryngeal cleft: a 10-year experience. Arch Otolaryngol Head Neck Surg 2006; 132 (12) 1335-1341
    CrossrefPubMedSearch in Google Scholar
  • 6 Kawaguchi AL, Donahoe PK, Ryan DP. Management and long-term follow-up of patients with types III and IV laryngotracheoesophageal clefts. J Pediatr Surg 2005; 40 (1) 158-164 , discussion 164–165
    CrossrefPubMedSearch in Google Scholar
  • 7 Evans KL, Courteney-Harris R, Bailey CM, Evans JN, Parsons DS. Management of posterior laryngeal and laryngotracheoesophageal clefts. Arch Otolaryngol Head Neck Surg 1995; 121 (12) 1380-1385
    Search in Google Scholar
  • 8 Antao B, Soccorso G, Bateman N, Shawis R. H-type tracheoesophageal fistula with type III laryngotracheoesophageal cleft. Eur Arch Otorhinolaryngol 2007; 264 (11) 1373-1376
    CrossrefPubMedSearch in Google Scholar
  • 9 Nakaoka T, Uemura S, Yano T , et al. Successful reconstruction of communicating bronchopulmonary foregut malformation associated with laryngotracheoesophageal cleft. J Pediatr Surg 2009; 44 (5) e29-e32
    PubMedSearch in Google Scholar
  • 10 DuBois JJ, Pokorny WJ, Harberg FJ, Smith RJH. Current management of laryngeal and laryngotracheoesophageal clefts. J Pediatr Surg 1990; 25 (8) 855-860
    CrossrefPubMedSearch in Google Scholar
  • 11 Ryan DP, Muehrcke DD, Doody DP, Kim SH, Donahoe PK. Laryngotracheoesophageal cleft (type IV): management and repair of lesions beyond the carina. J Pediatr Surg 1991; 26 (8) 962-969 , discussion 969–970
    CrossrefPubMedSearch in Google Scholar
  • 12 Moukheiber AK, Camboulives J, Guys JM, Riberi A, Paut O, Triglia JM. Repair of a type IV laryngotracheoesophageal cleft with cardiopulmonary bypass. Ann Otol Rhinol Laryngol 2002; 111 (12 Pt 1) 1076-1080
    PubMedSearch in Google Scholar
  • 13 Chitkara AE, Tadros M, Kim HJ, Harley EH. Complete laryngotracheoesophageal cleft: complicated management issues. Laryngoscope 2003; 113 (8) 1314-1320
    CrossrefPubMedSearch in Google Scholar
  • 14 Iskit SH, Senyüz OF, Sander S. Type IV laryngotracheoesophageal clefts: surgical management for long-term survival. J Pediatr Surg 1998; 33 (11) 1733
    PubMedSearch in Google Scholar
  • 15 Simpson BB, Ryan DP, Donahoe PK, Schnitzer JJ, Kim SH, Doody DP. Type IV laryngotracheoesophageal clefts: surgical management for long-term survival. J Pediatr Surg 1996; 31 (8) 1128-1133
    Search in Google Scholar