We report an improved technique for reconstruction of anterior commisure without a stent. A 66-year-old man with stoma opening because of the glottic and subglottic stenosis after right vertical hemilaryngectomy was operated on by the following technique. After a midline skin incision along the scar of the last operation, the adhesive scar of anterior part of the glottis and the subglottic was excised under laryngofissure. After the removal of the scar, the defect was covered with an island cervical skin flap on the right side and the defect of left side was transplanted by a free lip mucosal flap using human fibrin glue.
The glottic space became sufficiently enlarged for respiration and then the stoma could be closed 2 weeks after the surgery. Fibrin glue had adhesive effect in free mucosal transplantation for the defect of laryngeal mucosa without a stent.
This technique is useful for the reconstruction of anterior commisure without a stent in a case of severe glottic stenosis.