Get access

Repair of long type IV posterior laryngeal cleft through a cervical approach using cricotracheal separation

Authors

  • Evan J. Propst MD,

    1. Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
    2. Department of Otolaryngology–Head and Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
    Search for more papers by this author
  • Jonathan B. Ida MD,

    1. Division of Pediatric Otolaryngology–Head, Lurie Children's Hospital, Chicago, IL
    Search for more papers by this author
  • Michael J. Rutter MD

    Corresponding author
    1. Division of Pediatric Otolaryngology–Headd and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
    2. Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, U.S.A.
    • FRACS, Division of Pediatric Otolaryngology–Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039
    Search for more papers by this author

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

A female infant with CHARGE syndrome and a long type IV cleft extending to within 5 mm of the carina underwent transcervical repair at 5 weeks of age. The trachea was transected from the cricoid cartilage and was peeled off the esophagus. The front of the esophagus and the back of the trachea were repaired while still ventilating the patient. The trachea was reconnected to the cricoid cartilage. This technique obviated the need for a sternal split, thoracotomy, cardiopulmonary bypass, or extracorporeal membrane oxygenation. It improved visibility, access, airway stability, and coverage of the anastomosis with periosteum permitting a three-layer closure. Laryngoscope, 2013

Ancillary