Laryngeal cleft repair – Injection technique

Abstract

Laryngeal clefts are congenital airway anomalies resulting from incomplete development of the tracheoesophageal septum. Clinical presentation varies based on depth with type 1 clefts often manifesting with aerodigestive symptoms after the neonatal period. The diagnostic gold standard is microdirect laryngoscopy and bronchoscopy with interarytenoid palpation. Treatment of a type 1 cleft includes medical management, endoscopic repair, or injection laryngoplasty. Current literature has not outlined which children benefit from injection laryngoplasty versus endoscopic surgical repair. This article describes the operative technique of injection laryngoplasty for pediatric type 1 laryngeal clefts and provides strategies to help surgeons decide when to include this procedure. Laryngeal clefts are congenital airway anomalies resulting from incomplete development of the tracheoesophageal septum. Clinical presentation varies based on depth with type 1 clefts often manifesting with aerodigestive symptoms after the neonatal period. The diagnostic gold standard is microdirect laryngoscopy and bronchoscopy with interarytenoid palpation. Treatment of a type 1 cleft includes medical management, endoscopic repair, or injection laryngoplasty. Current literature has not outlined which children benefit from injection laryngoplasty versus endoscopic surgical repair. This article describes the operative technique of injection laryngoplasty for pediatric type 1 laryngeal clefts and provides strategies to help surgeons decide when to include this procedure.