In order to keep a record of stroboscopic images, we developed a video-tape recording system. This system can be utilized in the following manners:
(1) The physician can use not only verbal but also visual means of explanation of the patient's laryngeal condition.
(2) Teaching the various aspects of vocal fold vibration can be enhanced with the use of this dynamic method.
(3) More accurate information can be gleaned by allowing for more than one specialist to view the vocal fold in motion at the same time. In addition, this system permits repeated viewings at convenient times.
(4) One can compare vibratory patterns between different time points, including pre- and post-therapeutic examinations.
We also developed an additional system with which any waveforms displayed on an oscilloscope can be superimposed on the stroboscopic images.

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For early cancer of the vocal cord, cordectomy is one of the first choice among the successful surgical procedures. A very high cure rate has been reported when the lesion is confined to the membranous cord and the motion of the cord is not impaired. Although there has been a notable decline in the use of cordectomy due to the success of radiation therapy, a better survival rate is still obtained by cordectomy rather than by radiation according to our own experiences.
Hence, it is reasonable to consider that cordectomy should be more widely performed if excellent voice quality can be obtained postoperatively. From this viewpoint, we designed a new phonosurgical procedure to mobilize the false cord to replace the vocal cord after cordectomy.
After conventional laryngofissure and cordetomy, an incision is made into the false cord in order to make a flap which is to be used to replace the excised vocal cord. The displaced false cord flap is sewn by a fine suture under a microscope. The flap should be as thick as possible and should be sutured so that it protrudes as much as possible.
This newly disigned procedure has been employed for 7 cases. In this paper, the results are presented and discussed particularly from the viewpoint of phonodynamics. Considering the problems of late radiation change and possible oncogenesis, we believe that this functional microsurgery must be most appropriate for the treatment of early carcinoma of the vocal cord especially for patients of relatively young age.

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Laryngeal and tracheal specimens from 64 autopsy patients, 41 intubated and 23 non-intubated, were studied macro-and microscopically. The age of 64 patients varied from 1 month to 83 years. Intubated patients had endotracheal tubes continuously until their death, and the duration ranged 12 minutes to 521 hours.
Following results were obtained:
1) The most common lesions encountered were posterior ends of vocal cords, lateral and posterior walls of subglottis, and anterior and lateral walls of 5th and 9th tracheal cartilages, and also their neighbouring tracheal cartilages.
2) Mucous ulceration was found in 10 percent of specimens intubated less than 24 hours, but it was observed in all specimens intubated more than 3 days.
3) It is desirable to alternate endotracheal intubation with tracheostomy within 24 hours, at least within 48 hours.

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Three cases of the intratracheal granuloma arising at the tracheostoma are reported. These granulomas occurred after the tracheostomas had been closed. In these cases, we found some problems on the indication and technique of tracheotomy. These are as follows:
1) Extirpation of the granuloma under endoscopy should be primarily attempted. In recurrent cases, removal of the granuloma through the anterior neck route surgery should be performed.
2) We need to follow the patients up for at least three months after surgery, as the granuloma tends to recur.
3) Cricothyrotomy should be avoided.
4) In removal of foreign body in the air passage, tracheotomy should be avoided as far as possible.

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The author previously reported three cases of tracheal stenosis caused by prolonged intubation using cuffed tracheal tubes and cannulas. These patients were cured completely by repeated removals and electro-coagulation of granulation tissues under endoscopy.
This paper presents additional three cases, which were successfully treated by different conservative manipulations. In one case, a long-term intubation of a microporous EPTFE tube was applied to the Stenotic portion of the mediastinal trachea. In the other two cases, a T-shaped silicone tube was used. These manipulations are safe and applicable even with the patient in a serious condition,
The author claims that tracheal stenosis can be treated more successfully and easily by conservative manipulations.

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Recently, many reports of successful results in tracheo-bronchial anatomosis have appeared. However, there are vaious opinions with regard to suture technique and materials. In order to solve the problems of granulation and resultant stenosis of the airway and persistent coughing accompanying nonabsorbable suture materials, we considered the use of absorbable materials.
Performing experimental anastomosis of the trachea and bronchus on fifteen dogs using “Dexon” (absorbable), we subsequently observed the state of epithelial cell regeneration at the site of anastomosis at various intervals using scanning electron microscopy.
One week after anastomosis, initial stages of regeneration were evident in the incipient ciliation of the epithelium. At three weeks we observed goblet cells, and at nine weeks Apocrine secretory granula at the site of anastomosis. It was also found that the “Dexon” suture had begun diminishing three weeks after surgery. In a specimen observed after four months, no more suture material was visible.
We conclude that “Dexon”, as an absorbable suture material, is clinically usable in tracheobronchial anastomosis.

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We have tried to apply anti-cancer drugs by the method of arterial injection to inferior thyroid artery for the treatment of the laryngeal cancer. The patient was a 66-year-old Japanese male with the cancer mainly located in the posterior commissure of the larynx. After truncus thyreocervicalis and its branches were exposed, the Hakko's teflon tube with the outside diameter 1mm was retro-catheterized through transversa colli artery. We are always mindful of that an anatomical variety exists on truncus thyreocervicalis and inferior thyroid artery. Using dyestaining method we confirmed that the end of the catheter was definitely in truncus thyreocervicalis and not in subclavian artery. Thereafter, the catheter was fixed. It was then lead to the outside of the skin on the shoulder. Other arteries except ascending colli artery, which supplies partially the spiral cord, were ligated in expectation of effective arterial injection through inferior thyroid artery. Two modes of the treatment consisting of 5-FU arterial injection and irradiation were combined. The total dosage of the anti-cancer drug was 3, 125mg and irradiation dose was 2, 200rads. The tumor in the posterior commissure disappeared, but it remained in the farther anterior part of the commissure. This suggests that inferior thyroid artery might supply blood only to the region of posterior crico-arytenoid muscle, namely the region of the posterior commissure. Therefore, we directly injected 5-FU into the cricothyroid branch artery using Thermo 27G needle under microscope and simultaneously employed the radiotherapy. This arterial injection method is useful for the treatment of the laryngeal cancer without giving any dysfunction of cervical organs. The arterial injection method should be further developed for the treatment of head and neck cancer.

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Laryngeal web, whether its etiology be congenital or traumatic, is not a common disorder in the past. However, the wide-spread of laryngomicrosurgery has brought an increase of postoperative laryngeal web in recent years.
Three cases of postoperative laryngeal web successfully treated under the laryngomicroscopic procedure were reported. All the three cases developed postoperative laryngeal web after a simultaneous resection of bilateral vocal cord polypi or singer's nodules by laryngomicrosurgery. The treatment of laryngeal web consists of two steps, that is, resection of web and insertion of a silicon plate between the vocal cords to prevent recurrence of web under endolaryngeal microscopy. The technique was essentially the same as described by Saito et al (1973) and Nanjo et al (1976). The plate was kept in place for the period of one to four weeks until the complete reepithelization of the vocal cords was obtained. Postoperative voice improvement was excellent and all the three patients returned to their previous jobs without any clinical signs of recurrence.
The validity of endolaryngeal microsurgery using a silicon plate for the treatment of laryngeal web and the problem of an increasing risk to make iatrogenic postoperative laryngeal web in laryngomicrosurgery era were discussed.

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