Management of Symptomatic Grade I and II Laryngeal Cleft: Experience of a Tertiary Care Center and Review of Literature

Laryngeal cleft is a rare pathology and needs a high index of suspicion for diagnosis. Various classifications are used but the Inglis classification which describes 4 grades of cleft is most widely accepted. Grade 3 and 4 clefts are very rare and are usually associated with other congenital abnormalities. Grade 1 and 2 clefts are more common and can be easily corrected with good outcomes. We are presenting our experience with 9 cases of low grade (Grade 1 and 2) laryngeal cleft which were managed successfully in our department. Out of the 9 cases 4 failed conservative management and required a trans-oral repair. All patients improved with management, except one who intermittently developed another episode of pneumonia 2 months' post-surgery. However satisfactory cleft obliteration was confirmed on endoscopy and the patient has been under close follow up ever since. Majority of low grade laryngeal clefts can be managed with dietary modifications and feeding rehabilitation. Those who do not respond usually require surgical repair with near complete resolution of symptoms.