Laryngomicrosurgery Under General Anesthesia

Abstract

Highpoints of laryngomicrosurgery are described in this paper as the following :
1. Align head position appropriately for ideal exposure of the glottis.
The appropriate posture for direct laryngoscopy is the “Flexion-Extension” position. Suspension laryngoscopy and external counter pressure contribute to optimal exposure of the glottis.
2. Selection of laryngoscope.
Several types of laryngoscopes have been developed including round shaped, triangular shaped, retractable, etc. A posterior glottis laryngoscope was also developed for the management of posterior glottis lesions such as granulomas. It is important to have different types of laryngoscopes and to select the most appropriate one according to each lesion.
3. Selection of instruments.
There are several kinds of cold instruments as well as laser equipment. It is also important to use these instruments properly for each type of lesion.
4. Surgical technique.
Amputation or the micro-flap procedure should be selected for elevated lesions of the vocal fold on a case by case basis.