A laryngeal cleft is a gap in the tissues at the back of the voice box, which sometimes extends further down into the tissues that separate the windpipe and esophagus. Because the separation of the two tubes is not intact, foods and liquids that the child tries to swallow often goes down the windpipe. This results in chronic cough, chronic lung disease and recurrent pneumonias. These must be repaired surgically, and many of them can be repaired endoscopically (meaning without a neck incision). Occasionally, they must be repaired through an open incision on the neck.
The most common type, Type 1, is small, with the gap only above the vocal cords. Sometimes, Type 2 or Type 3 clefts extend further into the trachea and esophagus, making a larger opening between the two, with more severe swallowing problems. The most rare clefts, Type 4 can extend all the way into the chest, and require a very complex repair. Laryngotracheal clefts can be associated with some syndromes, including Pallister-Hall Syndrome, G syndrome (Opitz-Frias Syndrome), VACTERL association, and others.