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ENT · Larynx and airway: laryngeal cleft
Sample itemA newborn has a weak cry, choking with every feed and recurrent aspiration pneumonia. Laryngoscopy shows a defect of the posterior larynx between the arytenoids. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Laryngeal cleft
A laryngeal cleft is a failure of fusion of the posterior cricoid lamina, leaving a communication between the larynx and oesophagus that causes aspiration. Diagnosis is by microlaryngoscopy with palpation of the interarytenoid area. Repair is endoscopic or open according to the type.
Option by option
A. Subglottic haemangioma
Haemangioma presents with biphasic stridor at 2 to 3 months.
B. Laryngomalacia
Laryngomalacia causes inspiratory stridor without aspiration.
C. Vocal cord nodule
Nodules appear in older children after vocal abuse.
D. Laryngeal cleft (correct)
Correct. A posterior defect causing aspiration.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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