Toward a Functional Terminology: Reconsidering "Minor Laryngeal Clefts" as Interarytenoid Dysfunction.

Abstract

Much confusion surrounds the terminology used to describe minor laryngeal clefts in pediatric otolaryngology. The widely accepted Benjamin-Inglis classification defined type 1 clefts as those where the interarytenoid mucosal is at the level of the vocal folds. However, many children with aspiration and intact supraglottic mucosa respond favorably to interarytenoid augmentation. This finding has prompted the use of terms to suggest a deficient, and clinically significant, anatomic anomaly including "deep interarytenoid notch," "deep interarytenoid groove," "low interarytenoid height," and "type 1a cleft." These ambiguous terms are inconsistently applied, lack validated anatomic correlates, and hinder reproducible diagnosis and outcome comparison. We propose the term "interarytenoid dysfunction" (IAD) to replace these ambiguous descriptors, emphasizing the functional contribution of the interarytenoid region to airway protection rather than its often-indeterminate anatomic contour.