Laryngeal Cleft Overview
Laryngeal cleft is a rare abnormality of the separation between the larynx, or voice box, and the esophagus that occurs in less than one percent of the population.
When the larynx develops normally, it is completely separate from the esophagus. This allows swallowed foods to go directly into the stomach. A laryngeal cleft creates an opening between the larynx and the esophagus which can cause a danger of food and liquid going into the airway tube when a child swallows. Eating and breathing problems can be a result of this condition.
Children are born with a laryngeal cleft, which means it is present at birth (congenital). The cause is unknown, however, the abnormality happens during early months of pregnancy.
Types of Laryngeal Cleft
Depending on the size of the gap between the esophagus and the airway, the cleft can vary from mild to severe. The following are types of laryngeal clefts:
- Type I: The gap is located above the vocal cords (the mildest type).
- Type II: The cleft extends below the vocal cords into the lower cartilage of the voice box.
- Type III: The cleft extends beyond the voice box and into the trachea (windpipe).
- Type IV: The cleft extends even further down into the windpipe, and may go all the way to the bottom of the trachea (the most severe type).
Signs and Symptoms of Laryngeal Cleft
If your child has laryngeal cleft, you will most likely notice swallowing problems. Additional symptoms of this condition are:
- Choking or gagging while eating
- Poor weight gain
- Frequent respiratory infections
- Aspiration (food or liquid entering lungs)
- Gastric esophageal reflux
- Chronic lung disease
- Trouble breathing:
- Shortness of breath
- Short pauses when breathing (apnea)
- Noisy breathing (stridor)
Laryngeal Cleft Diagnosis
Laryngeal cleft is diagnosed through a comprehensive digestive evaluation while the child is under anesthesia. At times, a child may need other x-rays or tests to evaluate for aspiration or other abnormalities.
Treatment of Laryngeal Cleft
Laryngeal cleft is most often treated with surgery to close the opening in the larynx, or voice box.