Transoral approach to type 1 laryngeal cleft repair: A novel, non-endoscopic technique

Endoscopic type 1 laryngeal cleft repair under spontaneous ventilation can be difficult in patients with poor pulmonary reserve. Intubation makes visualization of the interarytenoid area challenging during an endoscopic repair. As an alternative technique, we utilized a transoral, non-endoscopic approach with a McIvor mouth gag in two such patients. This provided adequate visualization and a larger working field with readily available instrumentation. The ability to intubate the patient obviated the need to intermittently place an endotracheal tube and allowed for uninterrupted working time. This technique does require favorable patient anatomy for adequate exposure, but is worth considering in certain patients.