Health Topics

Children are born with a laryngeal cleft.  We do not know what causes a laryngeal cleft to occur, but it happens during the early months of pregnancy.  The cleft can vary from mild to severe; depending on how big the gap is between the esophagus and the airway.

• A type 1 laryngeal cleft is a gap that is located above the vocal cords. This is the mildest form.
• A type 2 laryngeal cleft extends below the vocal cords into the lower cartilage of the voice box. 
• A type 3 laryngeal cleft extends beyond the voice box and into the trachea (windpipe).
• A type 4 laryngeal cleft extends even further down into the windpipe, and may go all the way to the bottom of the trachea. This is the most severe form.

A child with a laryngeal cleft can have a wide range of signs and symptoms including:

• Coughing
• Choking with feedings
• Shortness of breath
• Poor weight gain
• Hoarseness
• Short pauses when breathing (apnea)
• Noisy breathing (stridor)
• Frequent lower respiratory infections (pneumonia)
• Food and / or liquid going into the lungs (aspiration)
• Gastric esophageal reflux

Some children, who have few symptoms and minor clefts, do not need surgery.  These children are checked often for any changes in their symptoms.   

If a child continues with aspiration or breathing concerns, the doctor will discuss what care options or surgeries are best for the child. Surgery for this condition is called a laryngeal cleft repair.