Clinical aspects of type 1 posterior laryngeal clefts: literature review and a report of 31 patients

Abstract

Objectives: The clinical relevance of posterior laryngeal clefts (PLCs) of type 1 has only recently been highlighted in the medical literature. We present a review of the literature and a report of a contributive series of 31 type 1 PLC patients.

Study design and methods: We performed a MEDLINE search of studies published between 1966 and September 2005 and a retrospective cohort study in children aged 0 to 16 years.

Results: In the reviewed articles as well as in the presented study, a high degree of comorbidity in patients with PLC type 1 is reported. The majority of patients (90%) with severe problems with oral feedings were treated conservatively by means of nasogastric tube feeding.

Conclusions: Increased awareness improves the chances of an accurate diagnosis of type 1 PLC in patients with congenital stridor. Type 1 PLC may be present in all patients with congenital stridor and laryngomalacia, particularly when stridor is accompanied by symptoms such as feeding difficulties and choking.