BackgroundThe laryngeal tube (LT), a closed esophageal supraglottic device comprising pharyngeal and esophageal cuffs, is used for emergency airway management. However, it is not often used in intraoperative airway management.Case presentationA 9-year-old boy was scheduled for a sialolithotomy for sialolithiasis. He had a history of surgery for tetralogy of Fallot and had undergone vocal cord fusion for postoperative left-sided vocal cord paralysis. Following a strong request by the mother to avoid tracheal intubation to reduce the risk of bilateral vocal cord paralysis, management without intubation was initially considered in the preoperative anesthesia plan. Airway management was planned using an LT in case of ventilation failure due to positional abnormalities. Although some leakage was observed during intraoral surgery, it was quickly resolved by adjusting the position of the LT outside the sterile surgical field.ConclusionsThe LT may be a viable option in cases where tracheal intubation is not preferred.