Clinical diagnosis and treatments of type Ⅱ-Ⅳ congenital laryngotracheoesophageal cleft in 8 children.
10.3760/cma.j.cn115330-20201029-00839
- VernacularTitle:Ⅱ~Ⅳ型先天性喉气管食管裂患儿八例临床诊治分析
- Author:
Jing ZHAO
1
;
Gui Xiang WANG
1
;
Hua WANG
1
;
Hong Bin LI
1
;
Feng Zhen ZHANG
1
;
Xiao Dan LI
1
;
Jin Shi HUANG
2
;
Jie ZHANG
1
;
Xin NI
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China Beijing Key Laboratory for Pediatric Diseases of otolaryngology Head and Neck Surgery,Beijing Pediatric Research Institute, Beijing 100045, China.
2. Department of Neonatal Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
- Publication Type:Journal Article
- MeSH:
Child;
Female;
Humans;
Infant;
Larynx/surgery*;
Male;
Retrospective Studies;
Trachea;
Tracheostomy;
Tracheotomy
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2021;56(9):972-976
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the clinical diagnosis and treatment of congenital laryngotracheoesophageal cleft (LTEC) in children. Methods: The clinical data of 8 children (including 7 males and 1 female)with congenital laryngotracheoesophageal cleft from January 2016 to June 2020 were retrospectively analyzed. The median diagnosing age was 3.75 months (5 days to 12 months). According to the modified Benjamin Inglis classification proposed by Sandu in 2006,there were 3 cases of type Ⅱ, 3 cases of type Ⅲa, 1 case of type Ⅲb and 1 case of type Ⅳa. All children were followed up regularly. Results: Six patients were treated for recurrent bronchopneumonia and aspiration during feeding. The patients were first treated in the pneumology departmentt or intensive care unit. Six patients combined with other malformations. Endoscopic repair operations were performed in 6 cases (3 cases of type Ⅱ, 3 cases of type Ⅲ a), 1 case of LTEC was operated through cervical approach, and 1 case of type IVa LTEC associated with VACTERL was repaired under thoracoscope combined with suspension laryngoscope. Seven patients underwent tracheotomy before or during the repair operations. Gastrostomy was performed in 2 children. The operations were successfully performed in all cases. Three children with type Ⅱ LTEC recovered well and decannulated. One case of type Ⅲa was followed up for 5 months with occasionally choking while feeding. Two cases of type Ⅲa, 1 case of type Ⅲb and 1 case of type Ⅳa died due to severe reflux, tracheomalacia or respiratory failure. Conclusions: Congenital LTEC is a rare congenital malformation which is difficult to diagnose for the poor specificity of clinical manifestations. LTEC needs to be classified by endoscopy examination under general anesthesia. Severe cases of LTEC have poorer outcomes than the mild cases, and the perioperative managements need multi-disciplinary cooperation to reduce the mortality.
