Reflux

Gastroesophageal reflux (GER) is a common condition in infants, though more common in babies born with a laryngeal cleft. With GER, stomach contents come back up into the esophagus and sometimes all the way back into the mouth. GER may or may not cause symptoms in babies and is typically outgrown. 

However, in a child with a laryngeal cleft, GER can cause a variety of problems. Because of the cleft between the esophagus and larynx, refluxed stomach contents may be aspirated into the lungs or cause other issues. In addition, if surgery is required to repair a child’s cleft, acidic reflux may cause healing difficulties. For these reasons and more, GER needs to be carefully managed in children with a laryngeal cleft.

Dysphagia

Swallowing difficulties, also known as dysphagia, are common in children born with a laryngeal cleft. Dysphagia makes the normally easy task of swallowing much more difficult. This condition is complex, with a wide variety of causes including anatomical abnormalities, delayed development, neuromuscular disorders, reflux, and more. This makes treatment for some laryngeal cleft children challenging. It’s important to work with your child’s doctor to determine the cause of dysphagia and the appropriate treatment.

Other related conditions

A laryngeal cleft can occur alone, but often a child with an airway cleft has other conditions that contribute to their difficulties, including:

  • laryngomalacia, tracheomalacia, bronchomalacia: floppy tissue in the larynx, trachea, or bronchi

  • subglottic stenosis: narrowing of the airway below the vocal cords 

  • TEF - tracheoesophageal fistula: a hole between the trachea and the esophagus

  • EA - esophageal atresia: the upper and lower parts of the esophagus are not connected

  • neuromuscular dysfunction

  • developmental delays

  • reactive airway disease

  • food allergies

  • FPIES: food protein-induced enterocolitis syndrome 

  • EOE: eosinophilic esophagitis 

  • other midline anomalies: heart defects, chiari malformation, tongue tie, hypospadias, etc.

  • specific genetic conditions

    • Opitz-Frias syndrome

    • VACTERL association

    • Charge syndrome

    • 22q11.2 deletion syndrome

    • Pallister-Hall syndrome

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Aspiration