Adult presentation of a tracheoesophageal fistula with co-existing laryngeal cleft

Congenital posterior laryngeal clefts are rare anomalies, being first descr ibed by Richter in 1792, and first operated upon successfully by Pettersson in 1955. Most clefts present within the first few months of life, with onl y a few cases being documented as presenting in adulthood. We present the c ase of a 50-year-old lady presenting with a previously undiagnosed posterio r laryngeal cleft with an associated tracheoesophageal fistula. The defect was graded as 2 on the Benjamin and Inglis classification system of posteri or laryngeal clefts. Following a literature review, we believe that our pat ient is the oldest to present with this congenital defect.