Ventilation Challenges Involved in a Rare Congenital Abnormality Masquerading as Esophageal Atresia: A Case Report

A premature neonate diagnosed with esophageal atresia secondary to polyhydramnios presented for diaphragmatic hernia repair. Preanesthesia evaluation suggested esophageal atresia with tracheoesophageal fistula. The decision was made to proceed with surgery; however, we were confronted with difficulty ventilating our patient. A few hours postsurgery, subcutaneous emphysema was appreciated in the neck region of our patient. On otolaryngological investigation, a single cleft running from the mouth until the carina was discovered. This rare deformity was a type 4 laryngeal cleft. This report will discuss both how we succeeded in ventilating our patient, and it will encourage extra diligence in preanesthesia evaluation.