{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T19:11:55Z","timestamp":1776625915172,"version":"3.51.2"},"reference-count":21,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p> To describe indications for injection augmentation (IA), endoscopic repair (ER) and conservative methods for the management of type 1 laryngeal cleft (LC1) and propose a management algorithm. We also aimed to compare success of IA and ER and determine independent predictors of treatment failure. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Retrospective study of patients diagnosed with LC1 at a Pediatric Otolaryngology referral centre between 2004 and 2016. All had pre-operative instrumental swallowing evaluation (VFSS\/FEES), and were managed with a combination of conservative measures, IA and\/or ER. We collected demographics, symptoms, comorbidities, VFSS\/FEES results, and operative details. The primary outcome was symptom resolution by parental report. The secondary outcome was predictors of treatment failure. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> 88 patients were included in the analysis, with mean age 26\u2009\u00b1\u200925\u2009months. Most presented with choking events (68%) or recurrent pneumonias (48%). In total, there were 55 IA performed and 45 ER. Of the patients who received IA, 19 required subsequent ER. 95% had symptom improvement, 67% had complete resolution. IA had a 56% long-term success rate, whereas that for ER was 85%. Tube feeding at initial evaluation was an independent predictor of treatment failure (HR 11.33 [1.51\u201384.97], p\u2009=\u20090.018). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> LC1 can be effectively managed with a combination of IA and ER with favorable results. Failure to respond to IA does not preclude ER, and both have their role in management. Patients who are tube fed have a higher probability of treatment failure. We propose a management algorithm that includes reasoning for conservative approaches, and reduces exposure to general anesthesia. <\/jats:p><\/jats:sec>","DOI":"10.1186\/s40463-020-00447-0","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T14:06:56Z","timestamp":1594735616000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Injection augmentation and endoscopic repair of type 1 laryngeal clefts: Development of a management algorithm"],"prefix":"10.1177","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1551-9588","authenticated-orcid":false,"given":"Andre","family":"Isaac","sequence":"first","affiliation":[{"name":"Pediatric Otolaryngology, Division of Otolaryngology Head & Neck Surgery, Departments of Surgery & Pediatrics, The Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orysya","family":"Svystun","sequence":"additional","affiliation":[{"name":"Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Johannsen","sequence":"additional","affiliation":[{"name":"Pediatric Otolaryngology, Division of Otolaryngology Head & Neck Surgery, Departments of Surgery & Pediatrics, The Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada"},{"name":"Outpatient Feeding & Swallowing Service, The Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamdy","family":"El-Hakim","sequence":"additional","affiliation":[{"name":"Pediatric Otolaryngology, Division of Otolaryngology Head & Neck Surgery, Departments of Surgery & Pediatrics, The Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada"},{"name":"Outpatient Feeding & Swallowing Service, The Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,1,1]]},"reference":[{"key":"bibr1-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1177\/000348948909800603"},{"key":"bibr2-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.12.025"},{"key":"bibr3-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.10.040"},{"key":"bibr4-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.03.015"},{"key":"bibr5-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.07.016"},{"key":"bibr6-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.5739"},{"issue":"4","key":"bibr7-s40463-020-00447-0","first-page":"231","volume":"17","author":"Slonimsky G","year":"2015","journal-title":"Isr Med Assoc J"},{"key":"bibr8-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1258\/0022215041917925"},{"key":"bibr9-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810395082"},{"key":"bibr10-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1177\/000348940010901101"},{"key":"bibr11-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811434004"},{"key":"bibr12-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26069"},{"key":"bibr13-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2008.04.010"},{"key":"bibr14-s40463-020-00447-0","unstructured":"American Speech-Language-Hearing Association. Feeding and Swallowing Disorders (Dysphagia) in Children. http:\/\/www.asha.org\/public\/speech\/swallowing\/Feeding-and-Swallowing-Disorders-in-Children\/. Published 2017. Accessed August 4, 2017."},{"key":"bibr15-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.05.024"},{"key":"bibr16-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1177\/0003489414539129"},{"key":"bibr17-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.12.032"},{"key":"bibr18-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27535"},{"key":"bibr19-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2006.07.021"},{"key":"bibr20-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1177\/0003489417752187"},{"key":"bibr21-s40463-020-00447-0","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.1252"}],"container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1186\/s40463-020-00447-0","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40463-020-00447-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1186\/s40463-020-00447-0","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40463-020-00447-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1186\/s40463-020-00447-0","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T13:28:54Z","timestamp":1741613334000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1186\/s40463-020-00447-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1186\/s40463-020-00447-0"],"URL":"https:\/\/doi.org\/10.1186\/s40463-020-00447-0","relation":{},"ISSN":["1916-0216","1916-0216"],"issn-type":[{"value":"1916-0216","type":"print"},{"value":"1916-0216","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"article-number":"49"}}