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Types

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Laryngeal clefts are classified according to how deep the abnormal opening extends downward towards the trachea and lungs. Two commonly used classifications systems are:

  • Benjamin and Inglis Classification — developed in 1989

  • Philippe Monnier Classification — developed in 2006

The Benjamin and Inglis Classification System 

This system categorizes laryngeal clefts into four types:

  • Type 1: the gap is above the vocal cords. This is the most mild cleft.

  • Type 2: the gap is below the vocal cords, but still within the larynx.

  • Type 3: the gap extends below the larynx into the trachea.

  • Type 4: the gap extends deeper into the trachea, past the collar bone (thoracic inlet), and may reach the bronchi (large tubes in the lungs). This is the most severe type of cleft. 

Diagram showing four types of laryngeal cleft with anatomical illustrations of the esophagus and trachea in each type.

Benjamin and Inglis Classification System.
Image provided by Otoscape website.

The Philippe Monnier Classification System 

This system expanded the Benjamin and Inglis system to include subcategories for types 3 and 4:

  • Type 1: the gap is above the vocal cords. This is the most mild cleft.

  • Type 2: the gap is below the vocal cords, but still within the larynx.

  • Type 3A: the gap extends through the entire larynx.

  • Type 3B: the gap extends through the larynx and into the trachea, but does not extend past the thoracic inlet.

  • Type 4A: the gap extends deep into the trachea and past the thoracic inlet.

  • Type 4B: the gap extends through the entire trachea and into a main bronchus . This is the most severe type of cleft.

Reviewed in 2024 by:
Reza Rahbar, MD, DMD — Pediatric Otolaryngology, Boston Children's Hospital
Michael Rutter, MD — Pediatric Otolaryngology, Cincinnati Children’s Medical Center