Laryngotracheal separation for a type 4 laryngotracheoesophageal cleft with multiple significant malformations

Laryngotracheoesophageal cleft (LTEC) is an extremely rare congenital malformation that is difficult to treat. We present a female patient with type 4 LTEC associated with multiple significant malformations. She suffered from a severe asthma attack due to aspiration of saliva, and it was determined that she should undergo surgery for associated congenital heart disease as early as possible to ensure long-term survival. Therefore, we performed laryngotracheal separation with an end-tracheostomy to completely and immediately prevent aspiration. She was then able to undergo radical surgery for her congenital heart disease. She recovered well postoperatively, and long-term survival is expected.