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A Combined Endoscopic CO 2 Laser and External Approach for Treatment of Glottic Cancer Involving the Anterior Commissure: An Animal Study
Author(s) -
Shapshay Stanley M.,
Wang Zhi,
Rebeiz Elie E.,
Perrault Donald F.,
Pankratov Michail M.
Publication year - 1996
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199603000-00006
Subject(s) - thyroid cartilage , anterior commissure , medicine , cartilage , surgery , laryngectomy , retractor , larynx , in vivo , anatomy , biology , microbiology and biotechnology
Endoscopic laser resection usually has been discouraged for anterior commissure (AC) carcinoma because of inadequate exposure and close proximity to underlying cartilage. A new technique combining endoscopic CO 2 laser incision and an external approach, creating a window in the thyroid cartilage, was tested in this in vivo study of six dogs. An en bloc specimen including adjacent cartilage was excised while preserving the thyroid framework. The glottic reconstruction was accomplished with external placement of a sternohyoid muscle flap, by either using a bipedicled muscle flap with overlying skin or a unipedicled muscle flap with a graft of free mucosa. The results showed a satisfactory anatomic reconstruction and acceptable functions. The bipedicled muscle flap was superior to the unipedicled muscle flap due to a better AC reconstruction. It is believed that this new combined technique may overcome limited access with endoscopic technique and excessive cartilage resection with the external partial laryngectomy.