Laryngotracheooesophageal Cleft Type IV with a Successful Correction
Introduction: Laryngotracheoesophageal cleft is a congenital malformation of the larynx and pharynx, with an abnormal, posterior communication, and possibly extending until the trachea and esophagus. It accounts for less than 2% of laryngeal malformations and may be associated with other malformations.
Objective: The study reports a case of a successful correction of a Stage IV laryngotracheoesophageal cleft with a 1-year follow-up.
Resumed Report: We present a case of stage IV laryngotracheoesophageal cleft successfully treated, born at 366/7 weeks, who was presented initially with respiratory distress and suspected laryngeal malformation by the pediatrician during orotracheal intubation after 15 hours of life. A contrasted x-ray was done and suggested esophageal atresia with fistula. The patient underwent direct laryngoscopy that confirmed a unique tube with complete communication between esophagus and trachea, from the larynx to the carina. A procedure with three stages, distal fistula closure, Stamm gastrostomy, and separation of tracheal and esophageal mucosae were performed, with confection of a cervical esophagostomy, isolating the airway of the esophageal segment. After 2 months, a tracheostomy was done. After 1 year, in the second procedure, the patient underwent a control laryngoscopy, evidencing pervious subglottis and trachea without fistulae or granulomas, although some degree of malacia was found.
Conclusion: It was a successful approach that leads to improvement in the patient quality of life and survival.