WordNet

having one or more incisions reaching nearly to the midrib (同)dissected
a split or indentation in something (as the palate or chin)
of or relating to or situated in the larynx; "laryngeal infection"
a musical notation written on a staff indicating the pitch of the notes following it

PrepTutorEJDIC

cleaveの過去・過去分詞 / (地面・岩などの)裂け目,割れ目,ひび
喉頭(こうとう)の;(音声が)喉頭音の
(楽譜の五線上の最初に付ける)音部記号

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/02/21 05:21:36」(JST)

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A laryngeal cleft or laryngotracheoesophageal cleft is a rare congenital abnormality in the posterior laryngo-tracheal wall.^[1] It occurs in approximately 1 in 10,000 to 20,000 births.^[2] It means there is a gap between the oesophagus and trachea, which allows food or fluid to pass into the airway.^[3]

Symptoms and diagnosis

Diagnosis of a laryngeal cleft in an infant often comes after problems with feeding which include coughing, cyanosis (blue skin) and failing to gain weight over time.^[3] Pulmonary infections are also common.^[4] The longer the cleft is, the more severe the symptoms. A cleft is diagnosed through endoscopic examination, specifically microlaryngoscopy and bronchoscopy.^[4]^[5] Laryngeal clefts are classified into four types according to length. Type I extends no further down than the vocal cords, type II extends below the vocal cords and into the cricoid cartilage, type III extends into the cervical section of the trachea and type IV extends the furthest—into the thoracic section of the trachea.^[5]

Treatment

Treatment of a laryngeal cleft depends on the length and resulting severity of symptoms. A shorter cleft (type I) may not require surgical intervention.^[5] Symptoms can be managed by thickening the infant's feeds.^[5] A slightly longer cleft (long type I or shorter type II) is repaired endoscopically. A cleft that is longer still (type II or type III) is repaired directly through the neck, with a tracheotomy.^[5]

Associated conditions

20–27% of individuals with a laryngeal cleft also have a tracheoesophageal fistula and approximately 6% of individuals with the fistula also have the cleft.^[4] Other congenital anomalies commonly associated with laryngeal cleft are gastro-oesophageal reflux, tracheobronchomalacia, congenital heart defect, dextrocardia and situs inversus.^[5] Laryngeal cleft can be a component of other genetic syndromes, including Pallister-Hall syndrome and G syndrome (Opitz-Friaz syndrome).^[4]

References

^ Thornton, M.; H. Rowley; B. J. Conlon; J. D. Russell (2001). "Type I laryngeal cleft: late presentation". Journal of Laryngology & Otology. 115 (10): 821–822. doi:10.1258/0022215011909053. PMID 11667997.
^ Pezzettigotta, S. M.; Leboulanger N.; Roger G.; Denoyelle F.; Garabédian E. N. (October 2008). "Laryngeal cleft". Otolaryngologic Clinics of North America. 41 (5): 913–33, ix. doi:10.1016/j.otc.2008.04.010. PMID 18775342.
^ ^a ^b Cherry, John R. (1997). Ear Nose & Throat for Lawyers. Routledge. p. 368. ISBN 1-85941-210-6.
^ ^a ^b ^c ^d Bluestone, Charles D. (2003). Pediatric otolaryngology, Volume 2. Elsevier Health Sciences. p. 1468. ISBN 0-7216-9197-8.
^ ^a ^b ^c ^d ^e ^f Graham, John M.; Glenis K. Scadding; Peter D. Bull (2008). Pediatric ENT. Springer. p. 193. ISBN 3-540-69930-9.

UpToDate Contents

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1. 喉頭の先天異常 congenital anomalies of the larynx
2. 小児における嗄声：病因およびマネージメント hoarseness in children etiology and management
3. 幼児および小児における嚥下障害による誤嚥 aspiration due to swallowing dysfunction in infants and children
4. 小児における慢性咳嗽に対するアプローチ approach to chronic cough in children
5. 小児における喘息以外の喘鳴疾患 wheezing illnesses other than asthma in children

English Journal

R368X mutation in MID1 among recurrent mutations in patients with X-linked Opitz G/BBB syndrome.

Preiksaitiene E1, Krasovskaja N, Utkus A, Kasnauskiene J, Meškienė R, Paulauskiene I, Valevičienė NR, Kučinskas V.
Clinical dysmorphology.Clin Dysmorphol.2015 Jan;24(1):7-12. doi: 10.1097/MCD.0000000000000059.
Opitz G/BBB syndrome is a genetically heterogeneous condition, with both autosomal dominant and X-linked forms. The MID1 gene is associated with X-linked Opitz G/BBB syndrome. Most mutations identified are unique, which makes it difficult to assess possible genotype/phenotype correlations. We report
PMID 25304119

Interarytenoid sodium carboxymethylcellulose gel injection for management of pediatric aspiration.

Horn DL1, DeMarre K2, Parikh SR3.
The Annals of otology, rhinology, and laryngology.Ann Otol Rhinol Laryngol.2014 Dec;123(12):852-8. doi: 10.1177/0003489414539129. Epub 2014 Jun 24.
OBJECTIVE: This study aimed to investigate the role of interarytenoid injection laryngoplasty (IL) for the management of pediatric aspiration.METHODS: Medical records of 30 patients, 9 female, with radiographically confirmed chronic aspiration who underwent intraoperative IL were retrospectively rev
PMID 24963090

Postoperative Observation of Children after Endoscopic Type 1 Posterior Laryngeal Cleft Repair.

Alexander NS1, Liu JZ2, Bhushan B3, Holinger LD3, Schroeder JW Jr4.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.Otolaryngol Head Neck Surg.2014 Nov 5. pii: 0194599814556068. [Epub ahead of print]
OBJECTIVES: To report the perioperative management and surgical outcomes in a large series of pediatric patients with endoscopically repaired type 1 posterior laryngeal cleft (PLC).STUDY DESIGN: Case series with chart review.SETTING: Urban, tertiary care, free-standing pediatric hospital.SUBJECTS AN
PMID 25378373

Japanese Journal

P-247 VATER症候群,喉頭気管食道裂を合併した食道閉鎖症の術後に気管軟化症が遷延した1例(ポスター臍・鼠径ヘルニア・精巣2,Better Life for Sick Children, Better Future for Pediatric Surgery,第45回日本小児外科学会学術集会)