Laryngeal cleft

Title

Other Names:

Posterior laryngeal cleft (PLC); Anterior submucous laryngeal cleft (subtype); Laryngo-tracheo-esophageal cleft; Posterior laryngeal cleft (PLC); Anterior submucous laryngeal cleft (subtype); Laryngo-tracheo-esophageal cleft; Laryngo-tracheo-esophageal diastema; LC; LTEC; Laryngotracheal cleft; Laryngotracheoesophageal cleft See More

Summary Summary

A laryngeal cleft is a rare malformation involving the larynx (known as the voice box) and the esophagus (known as the food pipe). Normally, when the larynx develops, it is completely separate from the esophagus so that swallowed foods travel directly through the esophagus into the stomach. A laryngeal cleft occurs when these structures do not develop normally in an embryo, and there is an opening connecting the larynx (and sometimes trachea) and the esophagus.^[1]^[2] This enables food and liquid that is swallowed to pass through the opening to the larynx, and into the lungs.^[1] Signs and symptoms may appear in the first few months of life and may include feeding problems, trouble swallowing, failure to thrive, reflux, coughing, wheezing, stridor, aspiration, respiratory distress, and recurrent lung infections.^[1]^[3] There are several different types of laryngeal clefts (types I through IV), which are classified based on the specific location and extent (severity) of the cleft.^[1]

A cleft can occur as an isolated abnormality, as part of an underlying syndrome or condition (such as Opitz-Frias, VACTERL, Pallister-Hall, CHARGE), or with other associated malformations.^[3] Treatment depends on the location and severity of the cleft and symptoms. For example, small clefts can sometimes be managed with medications to control symptoms such as reflux or aspiration, while some smaller clefts and larger clefts may need to be treated with endoscopic procedures or surgery.^[3]

Last updated: 7/16/2018

Symptoms Symptoms

A laryngeal cleft can be associated with a variety of symptoms depending on the type of cleft and the person's overall health.^[4] There are four types of laryngeal clefts (types I through IV), which are classified based on their specific location and size:^[4]^[1]

Type I clefts are the mildest; in this type the cleft (opening) between the larynx and the esophagus is located above the vocal cords. This type may not be diagnosed immediately (sometimes not until age 5), and in an otherwise healthy child it may not cause significant symptoms.
Type II clefts extend into the lower cartilage of the voice box, below the vocal chords.
Type III clefts extend beyond the voice box and into the trachea (windpipe).
Type IV clefts are the most severe, with the cleft extending even further down into the trachea (sometimes all the way to the bottom).

Initial symptoms of a laryngeal cleft may include coughing (especially with feeding), feeding difficulties, and some degree of respiratory distress (depending on the depth of the cleft). Other signs and symptoms may include aspiration, recurrent lung infections, stridor, wheezing, failure to thrive, and cyanosis (particularly in those with other underlying health problems or malformations).^[1]^[3]^[4][ Type III and IV clefts are associated with more severe respiratory symptoms, recurrent pneumonia, and excessive mucous in the lungs. Types III and IV usually become apparent within the first few days of life.^[4]

Last updated: 7/16/2018

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms	Other Names	Learn More: HPO ID
100% of people have these symptoms
Laryngeal cleft		0008751
30%-79% of people have these symptoms
Aspiration		0002835
Choking episodes		0030842
Cough	Coughing	0012735
Cyanosis	Blue discoloration of the skin	0000961
Dyspnea	Trouble breathing	0002094
Hoarse cry		0001615
Impaired oropharyngeal swallow response		0031162
Laryngomalacia	Softening of voice box tissue	0001601
Recurrent respiratory infections	Frequent respiratory infections Multiple respiratory infections respiratory infections, recurrent Susceptibility to respiratory infections [ more ]	0002205
Stridor		0010307
5%-29% of people have these symptoms
Neonatal respiratory distress	Infantile respiratory distress Newborn respiratory distress Respiratory distress, neonatal [ more ]	0002643
Percent of people who have these symptoms is not available through HPO
Abnormality of the voice	Voice abnormality	0001608
Autosomal recessive inheritance		0000007
Laryngeal stridor		0006511

Showing of 15 |

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Last updated: 10/1/2019

Treatment Treatment

The best treatment for a laryngeal cleft depends on the type of cleft and the severity of the symptoms it causes. In some cases, minor clefts (particularly types I or II) can be managed with medications that treat or prevent symptoms such as reflux or aspiration.^[3] Type I clefts may correct themselves as a person grows.^[5] A smaller-sized cleft that requires additional treatment may be treated with endoscopic repair. More severe clefts (particularly types III and IV) often require endocopic procedures or surgery.^[3]^[5]

Last updated: 7/16/2018

Statistics Statistics

The incidence of laryngeal clefts is approximately 1 in 10,000 to 20,000 live births.They are more common in boys than in girls, with a male-to-female ratio of 5:3.^[3]

Last updated: 7/16/2018

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Find a Specialist Find a Specialist

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference.

Organizations Organizations

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Laryngeal Cleft Support
Website: http://www.laryngeal-cleft.com

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Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

In-Depth Information

Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine.
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
PubMed is a searchable database of medical literature and lists journal articles that discuss Laryngeal cleft. Click on the link to view a sample search on this topic.

Selected Full-Text Journal Articles

Rahbar R, Rouillon I, Roger G, Lin A, Nuss RC, Denoyelle F, McGill TJ, Healy GB, Garabedian EN. The Presentation and Management of Laryngeal Cleft: A 10-Year Experience. Archives of Ololaryngology-Head & Neck Surgery. 2006; 132(12):1335-1341.

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My son was diagnosed with a laryngeal cleft 4 months ago and I can't find much information about this condition. Everything I read is from a medical journal. I'm just looking for more information about laryngeal cleft. See answer

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References References

Laryngeal Cleft. Boston Children's Hospital. http://www.childrenshospital.org/conditions-and-treatments/conditions/l/laryngeal-cleft. Accessed 7/16/2018.
Laryngotracheal Cleft (LTC). Children's Hospital of Philadelphia. https://www.chop.edu/conditions-diseases/laryngotracheal-cleft-ltc. Accessed 7/16/2018.
Isaacson GC. Congenital anomalies of the larynx. UpToDate. Waltham, MA: UpToDate; January 9, 2017; https://www.uptodate.com/contents/congenital-anomalies-of-the-larynx.
Johnston DR, Watters K, Ferrari LR, Rahbar R. Laryngeal cleft: evaluation and management. Int J Pediatr Otorhinolaryngol. June, 2014; 78(6):905-911. https://www.ncbi.nlm.nih.gov/pubmed/24735606.
Tewfik TL. Congenital Malformations of the Esophagus. Medscape Reference. March 8, 2017; http://emedicine.medscape.com/article/837879-overview.