Rapid Progression of Neonatal Respiratory Distress from Laryngeal Cleft Type I: A Case Report

Doi Yumi,Nishijima Eiji

doi:10.23937/2377-4630/1410127

Abstract

A one-month-old boy showed cyanosis and severe retraction on crying. He underwent diagnostic rigid bronchoscopy under general anesthesia, maintaining spontaneous ventilation. Rigid bronchoscopy revealed laryngeal cleft type I and excessive mucosa in the interarytenoid space that protruded into the subglottic area, very unusual findings in laryngeal cleft. His clinical condition quickly deteriorated and tracheotomy was performed to prevent complete airway obstruction in the few days until surgical repair of the cleft.

Highlights

Laryngeal cleft (LC) is a rare congenital malformation with an incidence of 1 in 10,000-20,000 live births [1]
Rigid bronchoscopy revealed laryngeal cleft type I and excessive mucosa in the interarytenoid space that protruded into the subglottic area, very unusual findings in laryngeal cleft
Tracheotomy is unnecessary in most cases of the laryngeal cleft type I, but it may be needed if the patient’s airway is severely compromised

Summary

Introduction

Laryngeal cleft (LC) is a rare congenital malformation with an incidence of 1 in 10,000-20,000 live births [1]. Aspiration, coughing, dyspnea, and cyanosis during feeding and crying are possible, while severe respiratory symptoms are rare. The patient was transferred to the pediatric intensive care unit (PICU) for close observation and prompt treatment in case of further respiratory deterioration. He was Citation: Doi Y, Nishijima E (2021) Rapid Progression of Neonatal Respiratory Distress from Laryngeal Cleft Type I: A Case Report. Rigid bronchoscopy was performed under general anesthesia, maintaining spontaneous respiration. For further examination and treatment, rigid bronchoscopy was scheduled under general anesthesia maintaining spontaneous respiration, to be followed by tracheotomy under tracheal intubation if necessary. Endoscopic repair of LC 1 was performed (Figure 2)

Discussion

Conclusion