Exploring surgical outcomes in endoscopic repair of type 1 laryngeal clefts (LC-1) and deep interarytenoid notches (DIN)

Abstract

The authors conducted a retrospective chart review evaluating the predictors of success for endoscopic repair of type 1 laryngeal clefts (LC-1) or deep interarytenoid notches (DIN). Demographics, birth history, medical comorbidities, surgical details, feeding history, and swallow function were collected (n = 52). Repair success was defined as improvement on videofluoroscopic swallowing study (VFSS) when initially evaluating the procedure's success (n = 36) and patient-reported symptom improvement when assessing predictive factors (n = 48). McNemar or McNemar-Bowker tests evaluated VFSS-assessed symptom improvement. Patients with post-operative symptom documentation were categorized based on predictors in outcome and assessed for post-operative improvement using the Pearson Chi-square test. Postoperatively, 58 % of patients with VFSS-identified aspiration had resolution. Dysphagia severity decreased (p = 0.009) with no severe cases post-repair. Furthermore, pregnancy complications, preterm birth, NICU stay, prior airway and feeding interventions, and syndromes were not significantly correlated with outcomes. However, trends in data suggest that preterm birth and NICU stay are more common in unsuccessful repairs. Overall, operative intervention significantly reduced aspiration and dysphagia severity.