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Laryngotracheoesophageal cleft

Gabriel Hernández, Francis D Beauchamp-Pérez, Carlos González-Aquino
Laryngotracheoesophageal cleft is a rare congenital malformation where a communication exists between the aero-digestive tracts that is associated with high morbidity and mortality. In this case series, we describe our experience with two neonates evaluated in our institution with two diverse initial presentations and symptomatology of type IV laryngotracheoesophageal clefts. One patient presented with acute distress and respiratory failure due to bowel contents obstructing the trachea and the other presented with mild subcostal retractions and inspiratory stridor without overt respiratory failure...
June 2018: International Journal of Pediatric Otorhinolaryngology
Steven E Sobol
Laryngotracheoesophageal cleft (LTEC) is a rare anatomic cause of aspiration in the newborn and infant. The clinical presentation of infants with LTEC is variable and will usually vary with the degree of anatomic communication between the airway and esophagus. The diagnosis of LTEC is often challenging, particularly in cases where the presentation and pathology are more subtle. Management of LTEC depends upon the clinical presentation, degree of aspiration, and anatomic depth of the cleft. The goal of this review is to present the clinician with a practical approach to diagnosis and management of this rare but challenging congenital airway anomaly...
March 2018: Current Problems in Pediatric and Adolescent Health Care
Evan J Propst
An 8 year-old female with esophageal atresia and a type IV laryngotracheoesophageal cleft underwent tracheostomy, gastric pull-up and fundoplication with G-tube insertion at birth. She remained nil per os due to aspiration. The trachealis was separated from the esophagus that was reapproximated and clavicular periosteum was placed. A long posterior costal cartilage graft that engaged behind the cricoid plate and tapered inferiorly was inserted. A second thin cartilage graft was sutured to it distally to extend the length of the repair...
December 2017: International Journal of Pediatric Otorhinolaryngology
Ahmad Khaleghnejad, Saeed Sadr, Seyyed Ahmad Tabatabaei, Nazanin Farahbakhsh, Payman Dabirmoghaddam, Saeed Saadat Mansori
Laryngotracheoesophageal clefts (LTEC) are rare malformations which involve the upper respiratory and digestive tract. Surgical repair should be undertaken promptly to maintain a secure airway and prevent serious pulmonary aspiration. This paper reports the first case of LTEC type 3 with severe laryngotracheomalacia that was brought to Mofid children's hospital in late infancy with a poor health status. Delayed defect correction was our team strategy for the patient when she had achieved good weight gain. At the age of 22 months in collaboration with the pediatric surgical and otolaryngologist team, the repair of the laryngeal cleft was done with lateral open approach method...
2018: Respiratory Medicine Case Reports
Kaan Sonmez, Ramazan Karabulut, Zafer Turkyilmaz, Canan Turkyilmaz, Berrin Isik, Sibel Eryilmaz, Kıvanc Seref, Ebru Ozcan, Gul Meral Hosgoren, Abdullah Can Basaklar
Laryngotracheoesophageal clefts (LTECs) are rare congenital defects that are often accompanied by additional anomalies. The major issues in the treatment of these patients are intraoperative exposure insufficiency, technical difficulty of the operation, and anesthesia problems originating from the respiratory tract. Problems originating from mechanical ventilation and respiratory tract, eating disorders and relapse of fistula are among the problems encountered following surgery. Most of the time, concomitant additional anomalies also worsen the clinical picture...
2017: Pan African Medical Journal
Julie E Strychowsky, Reza Rahbar
Laryngotracheoesophageal clefts are rare congenital anomalies of the aerodigestive tract. Patients may present with airway and/or swallowing impairments. An approach to evaluation and management is presented. Important pearls for conservative and surgical management are discussed. Open versus endoscopic surgical techniques are reviewed.
June 2016: Seminars in Pediatric Surgery
Koji Fukumoto, Go Miyano, Masaya Yamoto, Hiroshi Nouso, Hiromu Miyake, Masakatsu Kaneshiro, Hideaki Nakajima, Mariko Koyama, Kyoko Mochizuki, Masato Shinkai, Naoto Urushihara
BACKGROUND/PURPOSE: In Japan, surgical repair of a laryngotracheoesophageal cleft (LTEC) typically consists of the anterior approach, with the lateral approach as an alternative. Endoscopic surgery to repair the tracheoesophageal septum has been reported, and this study reviewed our experience treating several cases of LTEC endoscopically. METHODS: Endoscopic repair of LTEC was performed in 7 patients (3 boys, 4 girls; age range 4 months to 2 years 10 months; mean age 11 months; mean weight at surgery 7...
October 2015: Journal of Pediatric Surgery
Evan J Propst
UNLABELLED: An infant with a type IV laryngotracheoesophageal cleft underwent transcervical repair using a long tapered cartilage graft. A laryngofissure was carried down to the innominate artery to expose the cleft that extended 5 mm inferior to the vessel. The edges of the cleft were excised, the trachealis was separated from the esophagus that was reapproximated, and clavicular periosteum was placed. A long posterior costal cartilage graft that tapered inferiorly in anteroposterior dimension and engaged behind the cricoid plate was inserted...
April 2016: Laryngoscope
Daniel P Ryan, Daniel P Doody
Congenital obstructions and anomalies of the pediatric airway are rare problems that may be associated with mild symptoms or critical stenoses that may be life threatening in the first few days of life. This review provides an overview of the embryologic development of the airway, different congenital anomalies associated with airway development, and surgical correction that may be associated with good long-term outcome.
October 2014: Seminars in Pediatric Surgery
Kyoko Mochizuki, Masato Shinkai, Hiroshi Take, Norihiko Kitagawa, Hidehito Usui, Fumio Asano, Hisayuki Miyagi, Kouji Fukumoto
Type IV laryngotracheoesophageal cleft (LTEC) is a rare congenital anomaly that is associated with high morbidity and mortality despite various forms of surgical repair. This article presents our strategy for surgical management of type IV LTECs using a combination of lateral thoraco-cervical and laryngoscopic approaches.
September 2014: Pediatric Surgery International
Yvonne K Y Cheng, Jin Huang, Kwok Ming Law, Yiu Man Chan, Tak Yeung Leung, Kwong Wai Choy
BACKGROUND: Prenatal sonographic diagnosis of Optiz G/BBB syndrome is difficult because the common clinical features, such as hypertelorism, hypospadias and abnormalities of midline structures, including laryngotracheoesophageal defects, are subtle. METHOD: Chromosomal microarray (CMA) analysis using a target enriched Fetal DNA Chip design was performed on the DNA of a fetus with congenital cardiac abnormalities. RESULTS: Fetal DNA chip revealed a 48Kb single copy number loss within chromosome region Xp22...
September 25, 2014: Clinica Chimica Acta; International Journal of Clinical Chemistry
Douglas R Johnston, Karen Watters, Lynne R Ferrari, Reza Rahbar
OBJECTIVES: Review the latest diagnostic and treatment modalities for laryngeal and laryngotracheoesophageal clefts as they can be a major cause of respiratory and feeding morbidity in the infant and pediatric population. METHODS: Literature review of published reports. RESULTS: The presentation of laryngeal cleft usually involves respiratory symptoms, such as stridor, chronic cough, aspiration, and recurrent respiratory infections. Clefts of the larynx and trachea/esophagus can occur in isolation, as part of a syndrome (Opitz-Frias, VATER/VACTERL, Pallister Hall, CHARGE), or with other associated malformations (gastrointestinal, genitourinary, cardiac, craniofacial)...
June 2014: International Journal of Pediatric Otorhinolaryngology
Crispin Leishman, Philippe Monnier, Yves Jaquet
OBJECTIVE: To review the presentation and evaluation of laryngotracheoesophageal clefts as well as their treatment modalities, especially endoscopic closure. STUDY DESIGN: retrospective case series. METHODS: All patients treated for laryngotracheoesophageal clefts in our clinic during the last 15 years were included. Analysis of preoperative data, surgical success and functional outcome was performed. RESULTS: A total of 18 patients were included in our study...
February 2014: International Journal of Pediatric Otorhinolaryngology
Gali Pariente, Danielle Landau, Micha Aviram, Reli Hershkovitz
We report 2 cases of a rare sonographic appearance of duodenal atresia. The first was associated with severe hydramnios and a small, centrally located stomach. After birth due to recurrent pneumonia, bronchoscopy revealed a type 4 laryngotracheoesophageal cleft. The second case had an enlarged stomach without dilatation of the duodenum or hydramnios. After birth, radiography showed an enlarged stomach and duodenum: the classic "double bubble." The appearance of duodenal atresia on sonography is diverse. It may show a double bubble but may also show a single bubble: the stomach...
November 2012: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Shilpa Sharma, Amita Sen, Arti Maria, Jaswinder Kaur, Ashok Kumar, Rakesh Garg, Ajay Goila
No abstract text is available yet for this article.
June 2012: European Journal of Pediatric Surgery
James A Owusu, James D Sidman, Glen F Anderson
Laryngotracheoesophageal cleft (LTEC) is a rare congenital anomaly that results from failed posterior fusion of the cricoid cartilage and incomplete development of the tracheoesophageal septum. LTEC presents with increased secretions, respiratory distress, aspiration and recurrent pulmonary infections. The severity of presenting symptoms is dependent on the type of cleft. LTEC is most commonly classified into four types (I, II, III and IV) based on the inferior extent of the cleft. Types III and IV LTEC are associated with high morbidity and mortality and require timely diagnosis and repair for survival...
September 2011: International Journal of Pediatric Otorhinolaryngology
Christopher Dravis, Mark Henkemeyer
We report that the disruption of bidirectional signaling between ephrin-B2 and EphB receptors impairs morphogenetic cell-cell septation and closure events during development of the embryonic midline. A novel role for reverse signaling is identified in tracheoesophageal foregut septation, as animals lacking the cytoplasmic domain of ephrin-B2 present with laryngotracheoesophageal cleft (LTEC), while both EphB2/EphB3 forward signaling and ephrin-B2 reverse signaling are shown to be required for midline fusion of the palate...
July 1, 2011: Developmental Biology
Kenneth Geller, Young Kim, Jeffrey Koempel, Kathryn D Anderson
OBJECTIVE: The objective of this paper is to present our surgical experience with a cohort of four infants with laryngotracheoesophageal cleft (LTEC) in order to highlight our early failures and complications and to propose a comprehensive, three-layered approach in treating stages III and IV LTEC. METHOD: An IRB approved, retrospective chart review was carried out of a cohort of four cases occurring within a 2-year period of time. RESULTS: All patients had other significant anomalies, and the mortality rate was high: 75%...
June 2010: International Journal of Pediatric Otorhinolaryngology
Tatsuo Nakaoka, Sadashige Uemura, Tsunehiro Yano, Terutaka Tanimoto, Hiromu Miyake, Shingo Kasahara, Shunji Sano
A full-term newborn male infant presented with dyspnea and cleft lip and palate. He was thought to have esophageal atresia with tracheoesophageal fistula. He underwent bronchoscopy before operation that showed a laryngotracheoesophageal cleft (LTEC) type III. The left main bronchus originated from the lower esophagus. His diagnosis was communicating bronchopulmonary foregut malformation (CBPFM) type IA associated with LTEC type III. Enhanced chest computed tomographic scan showed the left pulmonary artery originated from the descending aorta...
May 2009: Journal of Pediatric Surgery
I Koerte, T Nicolai, I Joppich, D von Schweinitz, H-G Dietz
No abstract text is available yet for this article.
April 2009: European Journal of Pediatric Surgery
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