Clinical course following endoscopic repair of type 1 laryngeal clefts

Modified Best-Practice Algorithm to Reduce the Number of Postoperative Videofluoroscopic Swallow Studies in Patients With Type 1 Laryngeal Cleft Repair

“…13,14 Methods described to evaluate swallow function after laryngeal cleft repair include FEES, VFSS, or dye testing. 17 At Massachusetts…”

“…[8][9][10][11][12] Successful type 1 laryngeal cleft repair is often evaluated by VFSS. 5,10,13,14 There is no consensus as to the appropriate timing for the use of VFSS after laryngeal cleft repair. 10 Traditional practice at Massachusetts Eye and Ear was to obtain VFSSs on every patient at 6 weeks after repair.…”

Postoperative Observation of Children after Endoscopic Type 1 Posterior Laryngeal Cleft Repair

“…Eighty percent of their patients did not improve and went on to surgical repair. 9 Ketcham et al 10 (6) poor response to medical management and feeding therapy. 15 Bakthavachalam et al 1 reported 59 patients with type 1 PLCs.…”

“…Aspiration is the most common indication to pursue surgical management of a type 1 PLC, and both VFSS and FEES are suited to diagnose the presence of aspiration. 10,11,16,17 Eighty-nine percent of our patients were evaluated with VFSS at an average of 8 weeks postoperatively. We feel that this time frame is adequate for the resolution of any postoperative edema within the supraglottic larynx that may affect handling of thin liquids.…”

Use of Lasers in Laryngeal Surgery

“…Microflap surgery, for example, prevents clear visualization of the surgical plane and can result in hydrodissection of the normal basement membrane from the superficial lamina propria (23). However, unlike some laser procedures, microflap surgery does not usually require post-operative intubation (24), decreasing hospital stays and health care costs.…”