Laryngeal Cleft

What is a laryngeal cleft?

When a child’s larynx (voice box) develops normally, it is completely separate from the esophagus, so swallowed foods go directly into the stomach. A laryngeal cleft (or laryngotracheal cleft) is an abnormal opening between the larynx and the esophagus through which food and liquid can pass through the larynx into the lungs. This causes a number of eating and breathing problems.

Laryngeal clefts are classified in one of four ways:

  • Type I is the mildest form of laryngeal cleft. The gap between the larynx and the esophagus is located above the vocal cords.
  • Type II laryngeal cleft extends into the lower cartilage of the voice box, below the vocal chords.
  • Type III laryngeal cleft extends beyond the voice box and into the trachea (windpipe).
  • Type IV is the most severe form laryngeal cleft. The gap extends even further down into the windpipe, and may go all the way to the bottom of the trachea.

What are the symptoms of a laryngeal cleft?

If your child has a laryngeal cleft, you will most likely notice that he or she has trouble swallowing. When eating or drinking, for instance, liquids or food can go into your child’s lungs, which can make him or her inhale deeply and sometimes choke.

Other symptoms of the disorder include:

  • coughing
  • gagging
  • frequent respiratory infections

What causes a laryngeal cleft?

Laryngeal cleft is congenital, meaning it is present at birth. The cleft occurs during the early months of pregnancy, but we do not know why.

How we care for a laryngeal cleft

The Center for Airway Disorders at Boston Children's Hospital is designed to care for children with rare conditions of the airway, including laryngeal cleft. Our team provides the most advanced testing and airway treatments available for this condition.