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Proposal of landmarks for clamping neurovascular elements during endoscopic surgery of the supraglottic region
Author(s) -
Souvirón R.,
Maranillo E.,
Vázquez T.,
Patel N.,
McHanwell S.,
Cobeta I.,
Scola B.,
Sañudo J.
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.22902
Subject(s) - neurovascular bundle , anterior commissure , medicine , microsurgery , larynx , commissure , superior laryngeal nerve , anatomy , surgery
Background Bleeding within the supraglottic region can be a lethal complication after CO 2 laser microsurgery. Our aim was to propose endoluminal anatomical landmarks to locate the superior laryngeal vessels resulting in a safer microsurgery. Methods Endoluminal dissections were made in 22 larynges without laryngeal disease. Results The neurovascular structures were in the superior third of a triangle defined by the vocal process, the anterior commissure, and the epiglottic attachment of the aryepiglottic fold. They overlapped in 4 different ways: pattern I (70.4%): superior laryngeal vein (SLV), superior laryngeal artery (SLA), and internal laryngeal nerve (ILN); pattern II (13.6%): SLA, SLV, ILN; pattern III (4.6%): SLV, ILN, and SLA; pattern IV (4.6%): SLA, ILN, and SLV. Conclusion Microsurgery in the supraglottic region may be safer if surgeons are aware of the superior third of the above‐defined triangle, “danger area”, where the vascular elements of this region are located. © 2012 Wiley Periodicals, Inc. Head Neck, 2013