Prague Med. Rep. 2024, 125, 47-55

Laryngotracheoesophageal Cleft Type IV in a Preterm Neonate. A Case Report and Literature Review

Rozeta Sokou1,2, Anastasia Batsiou2, Aikaterini Konstantinidi2, Paschalia Kopanou-Taliaka2, Marina Tsaousi1, Maria Lampridou2, Evangelia-Filothei Tavoulari2, Konstantinos Mitropoulos2, Paraskevi Liakou2, Stamatina Willadara-Gamage2, Petros V. Vlastarakos3, Zoi Iliodromiti1, Theodora Boutsikou1, Nicoletta Iacovidou1

1Neonatal Department, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
2Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, Piraeus, Greece
32nd ENT Department, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece

Received August 18, 2023
Accepted January 30, 2024

We present a case of a preterm neonate with a type IV laryngo-tracheo-oesophageal cleft, an uncommon congenital malformation, resulting from the failure of separation of the trachea and the oesophagus during fetal development, often associated with other deformities as well. Data in the literature shows that the long-term morbidity from the entity has declined over the last decades, even though prognosis remains unfavourable for types III and IV. This report emphasizes the complex issues neonatologists are faced with, when treating neonates with this rare disorder in the first days of life, what will raise suspicion of this rare medical entity, and that direct laryngoscopy/bronchoscopy finally depicts the exact extension of the medical condition. At the same time extensive evaluation for coexisting congenital anomalies should be performed. For all the above reasons, these neonates should be treated in specialized tertiary pediatric centers for multidisciplinary prompt management, which may improve, the outcome.


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