Endolaryngeal suture technique using a silicon piece: A fast and convenient method

An endolaryngeal microsuture is one of the mandatory surgical techniques for most laryngological surgeons. It is required in many types of operations, such as vocal fold laceration repair, closure of a large endolaryngeal surgical defect, closure of a micropocket for implantation in vocal fold scar surgery, submucosal arytenoidectomy, flap suture in posterior glottis stenosis surgery, and many other microlaryngeal surgeries. The endolaryngeal microsuture technique has typically been reported with a focus on the knotting technique, such as the Indian tie, rather than a focus on the needling technique. There are many microinstruments, including laryngeal needle holders and curved alligator forceps, designed specifically for microsuture techniques. However, despite the use of such microinstruments, suturing of vocal folds, which involves handling of needles 20 cm apart from the hands with instruments in a limited working space, is still a challenging task for many laryngologists. Here, we report a better way to handle the needles using a silicon piece when performing an endolaryngeal microsuture, and evaluate the efficacy by having inexperienced surgeons try this new technique.