Author(s)
Cinzia Marchica
Anita Deshpande
Nikhila Raol
Affiliation(s)
Emory University
Abstract:
Objective: Describe the effect of laryngeal cleft injection compared to formal repair on swallowing oropharyngeal motility study(OPMS) results.Method: A retrospective chart review of children aged 0-18 years old with deep or type 1 laryngeal clefts having undergone injection followed by repair from 2014abstain018 was undertaken. Presenting symptoms, underlying medical diagnoses, oropharyngeal swallowing assessments as well as functional endoscopic evaluations of swallowing were reviewed. In cases where these studies were not available, parental reports were utilized. In particular, pre-injection, post-injection and post-repair OPMS results were reviewed.Results: Eighteen patients (9 female, 9 male) were identified as having undergone both laryngeal cleft injection followed by repair. Average age at time of injection was 2.7 years old (range 1.1-6.3 years), and at time of repair was 3.2 (range 1.6-6.9 years). Twelve patients were diagnosed as having a type 1 laryngeal cleft, whereas 6 were characterized as having a deep notch on diagnostic laryngoscopy. There was on average 203 days (78-482 days) between injection and repair. Finally, OPMS results were improved after repair compared to post-injection with penetration and aspiration of thin liquids being seen in 6 and 4 patients respectively after formal repair compared to 11 and 8 patients after injection. Similar findings were seen for nectar-thickened liquids.Conclusion: This study demonstrates that formal repair for laryngeal clefts may result in improved swallow function when compared to injection. This has important implications in limiting the number of operative procedures a child undergoes as well as radiation exposure from repetitive OPMS testing.