A New Technique of Glottal Incision in the Hemilaryngectomy

Abstract

In the frontolateral laryngectomy, the glottal incision has usually been performed upwards from the opening at the cricothyroid membrane. Since the lesion on the vocal fold is scarcely observed during procedure of cutting off, this technique is insufficiently reliable in cases which the lesion is located on bilateral folds.
In the authors' method, the vocal fold is excised under the direct observation downwards from the opening at the epiglottic petiolus. After the anterior portion of the thyroid cartilage is divided, the thyrohyoid membrane is horizontally incised just above the thyroid notch and the supraglottic space is opened. While bilateral thyroid alae are laterally and the divided anterior cartilage is downwards tracted, the supraglottic mucous membrane is cut down along the edge of the divided cartilage from the opening. The arytenoid is first visualized and the upper surface of the vocal folds and the anterior commissure come subsequently into the sight. The lesion on the vocal fold can be cut out at the most adequate site under the excellent direct view.