Fundamentals of Laryngeal Surgery: Approaches, Instrumentation, and Basic Microlaryngoscopic Techniques

Abstract

Laryngeal surgery can be done transorally or via an external approach. Open surgery is now restricted to ablative or reconstructive surgery at the cartilaginous framework of the larynx. Adequate endoscopy, functional evaluation of voice, swallowing and respiration as needed, and imaging provide the prerequisites for indicating, planning, and performing surgery of the larynx. Endolaryngeal surgery is done using Kleinsasser’s microlaryngoscopy technique. The CO2 laser meets the requirements for most benign and malignant laryngeal lesions, particularly in phonosurgery, stenosis surgery, swallowing rehabilitation, and the resection of most laryngeal tumours. Comprehensive surgical equipment, including a variety of different laryngoscopes, CO2 laser, electrocautery, microscope, and rigid endoscopes (0°, 30°, and 70°), should be available during laryngeal surgery. Endolaryngeal exposition of glottic and subglottic structures is best when jet ventilation is used in place of ventilation tubes.