CLEFT LARYNX - MANAGEMENT AND ONE-STAGE SURGICAL REPAIR BY ANTERIOR TRANSLARYNGOTRACHEAL APPROACH IN 2 CHILDREN

Cleft larynx is a rare congenital anomaly which is now being reported with increasing frequency. It is characterized by a midline posterior defect. Two children underwent laryngeal cleft repair by an anterior t ranslaryngeal approach. Tracheotomy was avoided and closure of the ant erior laryngofissure was carried out over the nasotracheal tube. The p atients were cared for in a pediatric intensive care unit until extuba tion. Extubation was performed on day 8. The older child had few funct ional problems and did well whereas the younger child did poorly. In t his latter case, the initially successful surgical result was impaired by post-operative aspiration, due to numerous possible factors: gastr oesophageal reflux secondarily controlled by Nissen fundoplication, di sturbed swallowing as a result more of the cleft repair work than of t he surgical approach, or else immaturity of the suction-swallowing ref lex.