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Management of the isolated congenital tracheo-oesophageal fistula.

Over a ten-year period sixteen infants with isolated congenital tracheo-oesophageal fistulas (TOF) were treated. All infants were symptomatic from birth although the diagnosis was only established in the neonatal period in eleven cases. Tube oesophagography was the diagnostic investigation of choice. Bronchoscopic cannulation of the fistula greatly assisted division, which was achieved through a cervical incision in all cases. There were two early recurrent fistulas both of which closed spontaneously. Persistent oesophageal symptoms were common. Seven of the patients (43%) experienced dysphagia, three of whom developed oesophageal strictures requiring repeated dilation.