Floyd Type III Tracheal Agenesis with Laryngeal Cleft and Bronchial Segment Absence: A Case Report
Article Sidebar
Main Article Content
Abstract
Introduction: Tracheal agenesis (TA) is a rare, life-threatening congenital anomaly characterized by complete or near-complete absence of the trachea. Floyd Type III, in which both main bronchi arise from the esophagus, represents one of the rarest variants. TA may be associated with other foregut derived malformations such as laryngeal clefts causing aerodigestive tract communication and bronchial hypoplasia or segmental absence, further complicating respiratory function.
Methods: A preterm female neonate with prenatal suspicion of esophageal atresia and cardiac defects underwent postnatal airway assessment via bronchoscopy and CT imaging.
Results: Findings confirmed Floyd Type III TA, an extensive laryngeal cleft, and missing bronchial segments on the left. Complex cardiac anomalies were also present.
Conclusion: This case highlights the importance of early airway imaging and endoscopy in diagnosing major congenital airway malformations and underscores the value of multidisciplinary care in complex neonatal presentations.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Share
References
1. Ergun S, Tewfik T, Daniel S. Tracheal agenesis: a rare but fatal congenital anomaly. McGill J Med. 2011 Jun;13(1):10. doi: 10.26443/mjm.v13i1.241
2. Hirakawa H, Ueno S, Yokoyama S, Soeda J, Tajima T, Mitomi T, Makuuchi H. Tracheal agenesis: a case report. Tokai J Exp Clin Med. 2002 Apr;27(1):1–7.
3. de Groot-van der Mooren MD, Haak MC, Lakeman P, et al. Tracheal agenesis: approach towards this severe diagnosis—case report and review of the literature. Eur J Pediatr. 2012 Mar;171(3):425–431. doi: 10.1007/s00431-011-1563-x
4. Tyler DC, Opitz JM, Reynolds JF. Laryngeal cleft: report of eight patients and a review of the literature. Am J Med Genet. 1985 May;21(1):61–75. doi: 10.1002/ajmg.1320210110
5. De Jong R, Hohman MH, Farahani C. Laryngeal clefts [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [updated 2025 Jun 16; cited 2025 Oct 1]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK616082/
6. Pfeifer M, Rehder H, Gerykova Bujalkova M, Bartsch C, Fritz B, Knopp C, Beckers B, Dohle F, Meyer-Wittkopf M, Axt-Fliedner R, Beribisky AV. Tracheal agenesis versus tracheal atresia: anatomical conditions, pathomechanisms and causes with a possible link to a novel MAPK11 variant in one case. Orphanet J Rare Dis. 2024 Mar 12;19(1):114. doi: 10.1186/s13023-024-03106-z
7. Dijkman K, Andriessen P, Lijnschoten G, Halbertsma F. Failed resuscitation of a newborn due to congenital tracheal agenesis: a case report. Cases J. 2009 Jul;2(1):7212. doi: 10.4076/1757-1626-2-7212
8. Lee S, Jackson J, Lakshminrusimha S, Brown E, Farmer D. Anatomic disorders of the chest and airways. In: Avery’s Diseases of the Newborn. 11th ed. Philadelphia: Elsevier; 2024. p. 626–658.e11. doi: 10.1016/B978-0-323-82823-9.00044-1
9. Rath S, Babarao S. Tracheal agenesis: a lethal malformation. Infant. 2015;11(4):131–132.
10. Abdellah LM, Faseeh NA, Abougabal MS, Farag MM. Retrospective study of congenital airway malformations detected by flexible fiberoptic bronchoscopy in Alexandria University Children’s Hospital. Egypt J Bronchol. 2023 Jul;17(1):31. doi: 10.1186/s43168-023-00208-3
11. Lacalamita MC, Fau S, Bornand A, et al. Tracheal agenesis: optimization of computed tomography diagnosis by airway ventilation. Pediatr Radiol. 2018 Mar;48(3):427–432. doi: 10.1007/s00247-017-4024-5
12. Straughan A. Tracheal agenesis: vertical division of the native esophagus—a novel surgical approach and review of the literature. Ann Otol Rhinol Laryngol. 2021 Jun;130(6):547–562. doi: 10.1177/0003489420962124
13. Fernández Monteagudo B, Piris Borregas S, Niño Díaz L, Carbayo Jiménez T, Morante Valverde R, Redondo Sedano JV, Moral Pumarega MT. Tracheal agenesis: the importance of teamwork in an uncommon pathology, challenging diagnosis, and high mortality—a case report. Front Pediatr. 2024 Jul;12:1401729. doi: 10.3389/fped.2024.1401729