In this episode, Dr. Hamdy El-Hakim, pediatric airway surgeon and Associate Professor at the University of Alberta, joins host Dr. Gopi Shah to review laryngeal clefts in children.

First, Dr. El-Hakim describes the presentation of laryngeal clefts. Affected children have coughing fits bad enough to cause watery eyes and “blue spells.” These fits are sometimes misattributed to other airway abnormalities or GERD. Then, discussion shifts to the workup of laryngeal clefts. All patients with a suspected laryngeal cleft need a comprehensive physical exam, a risk factor assessment and a swallow assessment, most commonly a FEES. Many patients will also require a diagnostic laryngoscopy with bronchoscopy (DLB). Dr. El-Hakim advises listeners on performing this test in children. Treatment of laryngeal clefts include thickened feeds, injection laryngoplasty, or surgical repair. Finally, Dr. El-Hakim advises listeners on compassionate care for families living with this condition.

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SHOW NOTES

00:00 - Introduction

03:39 - Laryngeal Clefts in Children: Diagnosis & Classification

06:36 - Presentation of Laryngeal Cleft

12:07 - Risk Factors & Associated Conditions

21:38 - Physical Examination Insights and Diagnostic Approaches

30:15 - The Role of FEES and Modified Barium Swallow in Diagnosis

37:37 - Navigating Pediatric Swallowing Disorders: Strategies and Challenges

41:12 - The Complexities of Diagnosing & Treating Laryngeal Cleft

45:28 - Surgical Techniques & Postoperative Care

01:03:13 - Evaluating Success Post-Surgery

01:09:20 - Final Thoughts: The Impact of Pediatric Dysphagia on Families

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RESOURCES

Dr. Hamdy El-Hakim’s University of Alberta Profile:

https://www.ualberta.ca/airway-research/iarc-team/hamdy-el-hakim.html

Article demonstrating superiority of cold steel relative to laser in type I laryngeal cleft repair:

https://pubmed.ncbi.nlm.nih.gov/34184769/