CONGENITAL LARYNGOTRACHEO-OESOPHAGEAL
CLEFT: A RARE CAUSE OF NEONATAL INSPIRATORY STRIDOR
Janssens LPF1, Tjon A Ten WE2,
Wouters B2
1 UMC St Radboud, Nijmegen, The Netherlands
2 St Joseph Hospital, Veldhoven, The
Netherlands
Methods: Four children with a
laryngotracheo-oesophageal cleft, a rare congenital malformation, are
described.
Results: All children had a stridor
shortly after birth. In two children the cleft was diagnosed the first day
of life, while in the other two diagnosis was delayed several weeks. Due to
the delay in diagnosis the risk of aspirations increased. The aspirations
cause lower respiratory infections and may ultimately lead to respiratory
failure. Because of these complications surgical correction of the cleft is
often delayed.
Conclusion: Considering the very low incidence of
laryngotracheo-oesophageal clefts this diagnosis is often not considered as
a cause of stridor in newborns. Confirmation of a cleft is possible by
direct laryngoscopy. As some children with a cleft produce excessive mucus,
a small cleft is easily missed, as the mucus covers the cleft. Endoscopy
under general anaesthesia is therefore essential in every child with a
stridor and/or frequent aspirations shortly after birth to exclude
laryngotracheo-oesophageal malformations.