A minor laryngeal cleft (type 1-a) diagnosed in infancy.

We report a case of laryngeal cleft. The patient showed tachypnea, stridor, and cyanosis with feeding, when the diagnosis was made by laryngo-fiberscopy at 2 days of life. At the age of 7 months, a direct laryngoscopy showed a 5 mm length of cleft behind the vocal cord at the level of the interarytenoid portion. Gastrostomy and tracheostomy were performed at the same time. For small type 1 clefts, some authors have proposed the possibility of treatment without surgery. In this case, we tried to minimize the defect by injecting collagen into the sub-mucosal space of the arytenoids. The patient was decanulated at the age of 2 years and 2 months. This case represents an example of earliest diagnosis of minimal laryngeal clefts (Armitage's type 1-a), which has been usually identified at older ages.