Experimental approaches to vocal fold alteration: Introduction to the minithyrotomy

Document Type

Journal Article

Publication Date

1-1-1999

Journal

Annals of Otology, Rhinology and Laryngology

Volume

108

Issue

1

DOI

10.1177/000348949910800101

Keywords

Anatomy; Lamina propria; Minithyrotomy; Scar; Thyrotomy; Vocal cord; Vocal fold

Abstract

Treatment of challenging laryngeal disorders, such as lamina propria loss or neuromuscular dysfunction, may require novel approaches and techniques. This paper discusses an evolution of experimental techniques for treatment of lamina propria loss and use of the minithyrotomy. These techniques have been used for surgical access for lamina propria substitution, as well as placement of stimulating electrodes. The minithyrotomy is tolerated well by patients, provides access for microscopic instruments with the surgeon's hand close to the tissue of interest, avoids intralaryngeal mucosal incisions, and lines up the direction of dissection in an anterior-to-posterior orientation. This orientation is favorable for particular situations herein discussed. We present anatomic and physiologic concepts relevant to the surgical treatment of lamina propria dysfunction, as well as presenting our clinical experience. This paper is not intended to state how these difficult problems should be handled, but rather, to present our experience in techniques that may prove useful through further development.

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