A case of atresia of the larynx.

Congenital abnormalities of the larynx and trachea rarely cause death in the newborn. Milder anomalies are not uncommon and are compatible with survival. Holinger, Johnson and Schiller (1954) reported a series of 379 cases, of which 305 were congenital laryngeal stridor. Among 19 cases of congenital web of the larynx three required tracheotomy and none died. This condition may persist without symptoms into adult life. One case of membranous atresia of the glottis survived after immediate tracheotomy. Congenital subglottic stenosis was found in 34 cases, in two of which it was due to deformity of the cricoid cartilage. Fourteen of these required tracheotomy. One case of cartilaginous stenosis died at the age of 4 weeks in spite of tracheotomy. There were five cases of congenital cyst and 15 of laryngocoele. Congenital papillomata and tumours such as haemangioma and lymphangioma have been reported. Kessel and Smith (1953) described a case of congenital absence of the trachea and reviewed the literature on tracheal anomalies. Subglottic cartilaginous atresia or stenosis is the least common anomaly. O'Kane (1936) described a case of stenosis which survived after tracheotomy and Baker (1954) reviewed the same case at the age of 18 years. Gunn (1926) referred to one case of partial and one of complete stenosis. Potter and Bohlender (1941) reported a case of atresia which died 20 minutes after birth and Potter (1952) referred to two other cases. Bizza (1941) described complete atresia in a stillborn infant with 'hyperplasia' of the lungs and referred to eight other cases in the German literature. Sayre and Hall (1954) reported one case of stenosis which survived for two days and one of atresia. They referred to 11 cases in the German literature. Sandison's (1955) case was associated with partial absence of the trachea and tracheo-oesophageal fistula. Of the above cases complete cartilaginous atresia was present in six and membranous atresia in one. Bizza (1941) and Sayre and Hall (1954) mention a further 11 cases in the German literature. The purpose of this paper is to describe a case of cartilaginous subglottic atresia and to discuss the embryology, diagnosis and possible treatment.