Laryngeal cleft.

Laryngeal cleft, first described by Richter in 1792, is a rarecongenital malformation. Diagnosis can be challenging and is contingent upon a high index of suspicion based on clinical presentation, interpretation of preoperative studies and a thorough endoscopic evaluation under general anesthesia whereby the posterior glottis is carefully palpated for any evidence of a cleft. Management involves feeding and medical therapy. When this fails, endoscopic repair is possible in type 1, 2 and selective type 3 laryngeal clefts. We describe the diagnosis and endoscopic management of type 1 laryngeal clefts, highlighting surgical pearls necessary for success.