Best of five
- A. Chest radiograph alone
- B. Flexible nasendoscopy alone
- C. Pure-tone audiometry
- D. Rigid airway endoscopy with palpation of the interarytenoid region
- E. Empirical fundoplication
FRCS (ORL-HNS) · SECTION 1 SBA
Type I laryngeal cleft
An infant has coughing and cyanosis with feeds, recurrent chest infections and persistent interarytenoid penetration despite reflux treatment. What investigation confirms a suspected laryngeal cleft?
D. Rigid airway endoscopy with palpation of the interarytenoid region
A small posterior cleft can be missed on flexible inspection. Controlled microlaryngoscopy and bronchoscopy with palpation defines its depth and associated airway lesions.
Why every option is right or wrong
A. Chest radiograph alone: It may show aspiration consequences but not the cleft.
B. Flexible nasendoscopy alone: A shallow cleft may be visually occult without palpation.
C. Pure-tone audiometry: This does not assess aspiration anatomy.
D. Rigid airway endoscopy with palpation of the interarytenoid region: A small posterior cleft can be missed on flexible inspection. Controlled microlaryngoscopy and bronchoscopy with palpation defines its depth and associated airway lesions.
E. Empirical fundoplication: Reflux surgery should not precede defining structural aspiration.
What if the scenario changed?
If aspiration were mild and improved with feeding modification, conservative therapy could precede endoscopic repair.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for current guidance, local policy and specialist judgement.
Back to the Section 1 bank