Type IV laryngotracheoesophageal cleft with associated pulmonary foregut malformation

Laryngotracheoesophageal clefts are rare anomalies usually diagnosed in early infancy with high rates of morbidity and mortality. Frequent complications after repair are tracheoesophageal fistula, tracheomalacia, and tracheostomy dependence. Here we describe the successful repair of a Type IV laryngotracheoesophageal cleft with an associated bronchopulmonary foregut malformation in a full-term female infant. In addition to a three-layered closure, costal cartilage grafts were used anteriorly and posteriorly to recreate the lamina of the cricoid. The placement of the grafts with the endotracheal tube acting as a stent, we believe, decreased the risk of fistula formation and helped to minimize post-operative tracheomalacia.