Fenda laríngea - Um desafio de diagnóstico e tratamento Laryngeal cleft - A diagnostic and treatment

Laryngeal clefts are a rare, underdiagnosed, with variable severity but potentially fatal disease. We report the case of an infant submitted on his first day of life to surgical repair of long hiatus oesophageal atresia with associated tracheoesophageal fistula. At 26 days of life he began enteral feeding by mouth, presenting six days later, whilst feeding, with an episode of dessaturation and extreme bradycardia which required resuscitation. Frequent episodes of rough breathing, similar to a snort, associated with crying were noticed. Laryngotracheal bronchoscopy showed changes in the anatomy of the larynx. Microlaringoscopy under anaesthesia confirmed a laryngeal cleft extending beyond the cricoid cartilage (type III). He underwent tracheostomy and endoscopic laryngeal cleft repair at three months of life, with good outcome. In these clinical situations, a high index of suspicion is warranted as early diagnosis allows for better survival.