Ep. 169 Navigating Type I Laryngeal Clefts in Children with Dr. Hamdy El-Hakim

In this episode, Dr. Hamdy El-Hakim, pediatric airway surgeon and Associate Professor at the University of Alberta, joins host Dr. Gopi Shah to review laryngeal clefts in children. First, Dr. El-Hakim describes the presentation of laryngeal clefts. Affected children have coughing fits bad enough to cause watery eyes and “blue spells.” These fits are sometimes misattributed to other airway abnormalities or GERD. Then, discussion shifts to the workup of laryngeal clefts. All patients with a suspected laryngeal cleft need a comprehensive physical exam, a risk factor assessment and a swallow assessment, most commonly a FEES. Many patients will also require a diagnostic laryngoscopy with bronchoscopy (DLB). Dr. El-Hakim advises listeners on performing this test in children. Treatment of laryngeal clefts include thickened feeds, injection laryngoplasty, or surgical repair. Finally, Dr. El-Hakim advises listeners on compassionate care for families living with this condition. --- SHOW NOTES 00:00 - Introduction 03:39 - Laryngeal Clefts in Children: Diagnosis & Classification 06:36 - Presentation of Laryngeal Cleft 12:07 - Risk Factors & Associated Conditions 21:38 - Physical Examination Insights and Diagnostic Approaches 30:15 - The Role of FEES and Modified Barium Swallow in Diagnosis 37:37 - Navigating Pediatric Swallowing Disorders: Strategies and Challenges 41:12 - The Complexities of Diagnosing & Treating Laryngeal Cleft 45:28 - Surgical Techniques & Postoperative Care 01:03:13 - Evaluating Success Post-Surgery 01:09:20 - Final Thoughts: The Impact of Pediatric Dysphagia on Families --- RESOURCES Dr. Hamdy El-Hakim’s University of Alberta Profile: https://www.ualberta.ca/airway-research/iarc-team/hamdy-el-hakim.html Article demonstrating superiority of cold steel relative to laser in type I laryngeal cleft repair: https://pubmed.ncbi.nlm.nih.gov/34184769/

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