Management of a grade I laryngotracheal cleft in a 4-month-old child with congenital lobar emphysema and severe pulmonary hypertension doi: 10.1111/j.1399-6576.2007.01360.x Sir, A 4-month-old, 3.66 kg male child, with a laryngotracheal cleft and congenital lobar emphysema, severe pulmonary hyperten- sion (80 mmHg) and patent ductus arteriosus (2 mmHg) was presented to us with chief complaints of regurgitation, breath- lessness and cough while feeding with no episodes of cyanosis. He had facial dysmorphism, a long philtrum, retrognathic mandible and a high-arched palate (Fig. 1). On pre-cordial auscultation, a pansystolic murmur was audible in the left Fig. 1. Shows facial dysmorphism with a long philtrum, retrognanthic mandible and a high-arched plane. 958 Letters to the Editor