Endoscopic repair of laryngeal cleft

Laryngeal cleft (LC) is a rare congenital malformation of the posterior larynx. Diagnosis requires a high index of suspicion because type 1 clefts, which are the most common, can be easily overlooked by the endoscopist. Timely diagnosis and appropriate treatment of LC are essential to prevent permanent pulmonary injury. Presenting symptoms include aspiration, cough, recurrent pneumonia, and dysphagia, with a wide range of severity. A trial of feeding therapy remains the management of choice for type 1 LC. When conservative measures fail, the next step in management is surgical repair. Endoscopic repair of LC is a well-tolerated and a reliable approach that considerably reduces perioperative and postoperative morbidity in type 1, type 2, and select type 3 LCs. In this article, we describe the endoscopic management of LCs, highlighting surgical pearls necessary for success.