Issue N# 3 - 2008
Isolated congenital tracheoesophageal fistula. Retrospective analysis of 8 cases and review of the literature
Authors : Biechlin A, Delattre A, Fayoux P. (Lille)
Ref. : Rev Laryngol Otol Rhinol. 2008;129,3:147-152.
Article published in french
Downloadable PDF document french
Objectives: The aim of this study was to evaluate clinical presentation, diagnostic and treatment modalities of isolated congenital tracheoesophageal fistula (“H-type fistula”). Methods: We report a retrospective analysis of 8 patients treated between 1998 and 2006 in a tertiary care centre. Results: Mean age at time of diagnosis was 22 days, the most frequent mode of presentation was with respiratory symptoms during feeding (coughing, choking). Diagnosis was performed using flexible laryngotracheal endoscopy and rigid tracheoscopy under general anaesthesia, associated to a malformative assessment. Treatment was based on surgical closure by right cervicotomy. No per or post-operative complication was observed. Extubation was realized after 3.6 days and oral feeding was reintroduced after 5.5 days. Follow-up revealed one case of tracheomalacia and two patients required a gastrostomy. No recurrence was observed. Conclusion: The tracheoesophageal congenital isolated fistula is a rare malformation. Recurrent respiratory symptoms should alert to this diagnosis. The simplest and more efficient diagnosis method seems to be flexible laryngotracheal endoscopy. Surgical treatment by cervicotomy must be performed without any delay. A long-term follow-up is necessary because of the recurrence risk.
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