EN
TÜRKÇE
Oral Presentation - 3
Increased Prevalence of Laryngeal Clefts in Patients with Vascular Rings
I O'Riordan*, L Cole**, A Mohamed**, B Zendejas**, S Choi*
*Boston Children's Hospital, Department of Otolaryngology and Communication Enhancement, Boston, USA
**Boston Children's Hospital, Department of Surgery, Esophageal and Airway Treatment Center, Boston, USA
Introduction The prevalence of laryngeal clefts in patients with vascular rings has not been described in the literature. We hypothesize that patients with vascular rings are at increased risk of laryngeal clefts from abnormal embryological development of the aerodigestive system. This study aims to evaluate the prevalence of laryngeal clefts diagnosed in patients with vascular rings.
Methods We evaluated an IRB-approved prospective database of patients presenting to our Vascular Ring Center from 2016 to 2024. Data collected included demographics, type of vascular ring, syndromic diagnoses, presenting symptoms, nature of dysphagia, vocal fold mobility, and presence of laryngeal clefts identified on direct laryngoscopy and tracheobronchoscopy (DLB). We excluded patients with a history of esophageal atresia as they are known to have an increased prevalence of laryngeal clefts.
Results A total of 222 patients were analyzed. The male to female ratio was 1.2: 1. The mean age at presentation was 4 years (range: day 1 of life to 18 years, median: 19 months) Underlying genetic diagnosis were present in 25 patients (11%); 22q11 deletion syndrome and Trisomy 21 were the most common diagnoses. Of the entire cohort, 121 patients had a modified barium swallow, and 29 patients (32%) demonstrated aspiration.
There were 120 patients who had a DLB performed by otolaryngology. A laryngeal cleft was diagnosed in 25 patients (21%). Of these patients, 23 had type 1 laryngeal clefts and 2 had type 2 laryngeal clefts. Five patients (20%) underwent laryngeal cleft repair.
Conclusion Pediatric patients with vascular rings often present with diverse respiratory and swallowing symptoms. Our findings reveal an increased prevalence of laryngeal clefts and aspiration risk in this population compared to the general population. We recommend that patients with vascular rings undergo multidisciplinary evaluations with attention to aspiration symptoms warranting evaluation for laryngeal cleft.