Instrumentation: Cross table operating microscope

This video demonstrates a transventricular subtotal excision of a recurrent laryngeal saccular cyst, including partial excision of the false vocal cord, performed using the COMET approach (Combined Microscopic and Endoscopic Technique). The cyst had initially been managed with supraglottic decompression on the 5th day of life, which failed, leading to recurrence with progressive respiratory distress over the following days and necessitating re-intubation.