Laryngeal cleft type I: a novel method of repair using Bioplastique™

Ahluwalia, Suki; Pothier, David D.; Philpott, Jonathan M.; Sengupta, Papiya; Frosh, Adam

doi:10.1258/0022215041917925

Cited by 11 publications

(8 citation statements)

References 8 publications

(8 reference statements)

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“…The overall number of patients with T1LCs in previous studies is quite small, ranging from 1 to 41 [1][2][3][4]6,7,9,10,13,[15][16][17][18][19], with even fewer reported closures. Our surgical success rate is lower than the success rates of 80-100% reported [1,7,9,10] despite our low postoperative complication rate.…”

Section: Discussionmentioning

confidence: 97%

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Clinical course following endoscopic repair of type 1 laryngeal clefts

Ketcham

Smith

Lee

et al. 2008

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 97%

“…Injection of gelfoam, collagen, and Bioplastique into T1LCs has also been found to improve aspiration [16,17,19]. Case series using microflap repair report Endoscopic repair of T1LCs 1265 Fig.…”

Section: Discussionmentioning

confidence: 99%

Clinical course following endoscopic repair of type 1 laryngeal clefts

Ketcham

Smith

Lee

et al. 2008

International Journal of Pediatric Otorhinolaryngology

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“…Endoscopic repairs are usually reserved for type I and minor type II clefts according to the previously mentioned classification 1,11,13 . Kennedy et al 15 have reported success in the management of type I laryngeal clefts (LC) by Gelfoam injection into the interarytenoid region and Ahluwalia et al 14 by staged injections of Bioplastic into the posterior commissure.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Laryngotracheal Cleft Repair Without Tracheotomy or Intubation

Sandu

Monnier

2006

The Laryngoscope

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“…Since its early beginning in the 1980's, numerous publications have described the endoscopic technique for the closure of type I and type II LC [8,29,41,55,58,60,63,64]. Recently, successful cases of endoscopic closure of type III clefts have also been reported [58,60].…”

Section: Reviewmentioning

confidence: 99%

“…However, authors have experienced the use of complementary materials, with varying success rates: collagen [65], Gelfoam ® [66], and more recently bioplastic [64], in order to improve long-term results, Bioplastic beingless absorbable than the previous materials. These procedures with injectable materials have been mostly proposed in type I clefts and remain used by few teams.…”

Section: Reviewmentioning

confidence: 99%

Laryngo-tracheo-oesophageal clefts

Leboulanger

Garabédian

2011

Orphanet Journal of Rare Diseases

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A laryngo-tracheo-esophageal cleft (LC) is a congenital malformation characterized by an abnormal, posterior, sagittal communication between the larynx and the pharynx, possibly extending downward between the trachea and the esophagus. The estimated annual incidence of LC is 1/10,000 to 1/20,000 live births, accounting for 0.2% to 1.5% of congenital malformations of the larynx. These incidence rates may however be underestimated due to difficulty in diagnosing minor forms and a high mortality rate in severe forms. A slightly higher incidence has been reported in boys than in girls. No specific geographic distribution has been found. Depending on the severity of the malformation, patients may present with stridor, hoarse cry, swallowing difficulties, aspirations, cough, dyspnea and cyanosis through to early respiratory distress. Five types of laryngo-tracheo-esophageal cleft have been described based on the downward extension of the cleft, which typically correlates with the severity of symptoms: Type 0 laryngo-tracheo-esophageal cleft to Type 4 laryngo-tracheo-esophageal cleft. LC is often associated with other congenital abnormalities/anomalies (16% to 68%), mainly involving the gastro-intestinal tract, which include laryngomalacia, tracheo-bronchial dyskinesia, tracheo-bronchomalacia (mostly in types 3 and 4), and gastro-esophageal reflux disease (GERD). The syndromes most frequently associated with an LC are Opitz/BBB syndrome, Pallister Hall syndrome, VACTERL/VATER association, and CHARGE syndrome. Laryngeal clefts result from failure of fusion of the posterior cricoid lamina and abnormal development of the tracheo-esophageal septum. The causes of the embryological developmental anomalies leading to LC are not known but are thought to be multifactorial. LC appears to be mostly sporadic although some familial cases with suspected autosomal dominant transmission have been reported. The age of diagnosis depends mainly on the severity of the clinical symptoms and therefore on the extent of the LC. Diagnosis is made either based on clinical manifestations or on investigations, such as endoscopy, X-ray, CT scan, performed for other conditions. Differential diagnoses include tracheo-bronchial fistula, gastro-esophageal reflux disease and neurological swallowing disorders, as well as laryngomalacia and laryngeal palsy. Prenatal diagnosis of LC has never been reported, although associated anomalies may be detected on fetal ultrasonography. Once the cleft is diagnosed, it is essential to determine its length to orient the management and treatment approach. Management involves maintenance of satisfactory ventilation, prevention of secondary pulmonary complications as a result of repeated aspirations, and adequate feeding. Endotracheal intubation may be required for respiratory distress in severe cases. Treatment requires endoscopic or external surgery to close the cleft. Surgery should be performed as early as possible to avoid complications related to aspiration and gastric reflux, except in type 0 and type 1 cases in ...

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Laryngeal cleft type I: a novel method of repair using Bioplastique™

Cited by 11 publications

References 8 publications

Clinical course following endoscopic repair of type 1 laryngeal clefts

Clinical course following endoscopic repair of type 1 laryngeal clefts

Endoscopic Laryngotracheal Cleft Repair Without Tracheotomy or Intubation

Laryngo-tracheo-oesophageal clefts

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