Adult presentation of a tracheoesophageal fistula with co-existing laryngeal cleft

Congenital posterior laryngeal clefts are rare anomalies, being first described by Richter in 1792, and first operated upon successfully by Pettersson in 1955. Most clefts present within the first few months of life, with only a few cases being documented as presenting in adulthood. We present the case of a 50-year-old lady presenting with a previously undiagnosed posterior laryngeal cleft with an associated tracheoesophageal fistula. The defect was graded as 2 on the Benjamin and Inglis classification system of posterior laryngeal clefts. Following a literature review, we believe that our patient is the oldest to present with this congenital defect.