Health Library

Laryngeal Atresia

Diagnosis

Laryngeal atresia is often found during a routine prenatal ultrasound. But it may not be noticed during pregnancy. If found at birth, the baby will have severe breathing problems.

Initial Lifesaving Measures

If the condition was not found during pregnancy, an incision is made into the lower part of the windpipe (trachea) right after the baby is born. This is done to allow them to breathe. A trach tube is placed through this opening and breathing is done through this tube rather than through the nose and mouth.

If the laryngeal atresia is found before birth, the baby is delivered by the ex-utero intrapartum treatment procedure (called EXIT). The EXIT procedure is done in an operating room set up to treat mother and baby in one location.

Treatment

When the baby is stable, a team of experts does a full exam. At Cincinnati Children’s, this includes members of our Aerodigestive and Esophageal Center who will discuss their findings and treatment plan with you. The focus of early treatment is to get the baby ready for surgery to repair the airway. This may include treating other conditions that may affect the success of the surgery. In most cases, open laryngeal reconstructive surgery is recommended. This surgery involves placing grafts in the airway to make the airway bigger. A stent is typically placed in the airway to keep the grafts in place while they heal. During this time, the baby’s tracheotomy tube will remain in place.

Surgery for these children is challenging. Many children need more than one operation before removing the tracheotomy.

Long-Term Outlook

Many children with laryngeal atresia need multiple operations during their lifetime. They may have voice problems as they grow. Their voice will sound different because it will not come from the vocal cords. Such post-surgical voice problems can be managed by a team of voice experts at Cincinnati Children’s Center for Pediatric Voice Disorders.