Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-23T23:04:44.929Z Has data issue: false hasContentIssue false

Surgical approach to submucosal lesions of the supraglottic larynx: the supero-lateral thyrotomy

Published online by Cambridge University Press:  29 June 2007

John S. Rubin*
Affiliation:
Department of Otorhinolaryngology, Montefiore Medical Centre, Bronx, NY, USA.
Carl E. Silver
Affiliation:
Department of Surgery, Montefiore Medical Centre, Bronx, NY, USA.
*
Dr John S. Rubin, M.D., Department of Otorhinolaryngology, Montefiore Medical Center, 111 East 210th Street, Bronx, New York, USA.

Abstract

The surgical approach to the hypopharynx by lateral pharyngotomy as described by Trotter has found widespread use in management of supraglottic carcinoma. A similar but more conservative approach may be employed for removal of cysts and benign or well-encapsulated neoplasms of the epiglottis and supraglottic space. We call this approach a supero-lateral thyrotomy, to differentiate it from the classic lateral pharyngotomy.

Surgery consists of subperichondrial resection of the superior half of the ipsilateral thyroid cartilage with preservation of internal lining and superior laryngeal nerve. The lesion may then be enucleated or resected, and the defect, if any exists, closed with overlying mucosa and the flap of preserved perichondrium. The technique has been employed in cases of paraganglioma, haemangiopericytoma and saccular cysts.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This paper was presented at the Eastern and Canadian Regional meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Boston, USA on 12 January 1991.

References

Alonso, J. M. (1952) Conservation of function in surgery of cancer of the larynx: bases, technics and results. Transactions of the American Academy of Ophthalmology and Otolaryngology, 56: 722730.Google Scholar
Beekhuis, G. J., Croushore, J. E. (1963) Surgical approach to neoplasms of the mesopharynx. Laryngoscope, 73: 519536.CrossRefGoogle Scholar
Blassingame, C. D. (1952) The suprahyoid approach to surgical lesions at the base of the tongue. Annals of Otology, Rhinology and Laryngology, 61: 483489.CrossRefGoogle ScholarPubMed
Booth, J. B., Birck, H. G. (1981) Operative treatment and postoperative management of saccular cyst and laryngocele. Archives of Otolaryngology, 107 (8): 500502.CrossRefGoogle ScholarPubMed
Cheever, D. W. (1878) Cancer of the tonsil: removal of the tumour by external incision (A second case). The Boston Medical Journal, 99: 133139.CrossRefGoogle Scholar
Grunwald, L. (1906) Pharyngotomia suprahyoidea. Zentralblatt fur Chirugie. 36: 972973.Google Scholar
Harris, P. E., Rosenfeld, L., Ward, P. H. (1968) Lateral pharyngotomy approach for lesions of the base of the tongue, pharynx and larynx. Southern Medical Journal, 61: 12761280.CrossRefGoogle ScholarPubMed
Holinger, L. D., Barnes, D. R., Smid, L. J., Holinger, P. H. (1978) Laryngocele and sacular cysts. Annals of Otology, Rhinology and Laryngology, 87: 675685.CrossRefGoogle Scholar
Jeremitsch, T. (1985) Pharyngotomia suprahyoidea (proprie sic dicta). Archiv fur Klinische Chirurgie Berlin, 49: 793802.Google Scholar
Kloop, C. T., Delaney, A. (1950) Anterior (median) pharyngotomy. Archives of Surgery, 60: 11611170.CrossRefGoogle Scholar
Komisar, A. (1987) Laser laryngoscopic management of internal laryngocele. Laryngoscope, 97: 368369.CrossRefGoogle ScholarPubMed
LeRoux-Robert, J. (1965) Les possibilities therapeutiques du cancer du larynx par la chirurgie et les associations radio-chirurgicales a propos d'une statisque personelle de 1,000 cas operes depuis plus 5 ans. La Presse Medicate, 73: 10311036.Google Scholar
Myssiorek, D., Persky, M. (1989) Laser endoscopic treatment of laryngoceles and laryngeal cysts. Otolaryngology—Head and Neck Surgery, 100 (6): 538541.CrossRefGoogle ScholarPubMed
Orton, H. B. (1930) Lateral transthyroid pharyngotomy: Trotter's operation for malignant conditions of the laryngopharynx. Archives of Otolaryngology, 12: 320328.CrossRefGoogle Scholar
Portmann, G. (1949) Surgery at the base of the tongue by transpharyngeal approach. Archives of Otolaryngology, 50: 373376.CrossRefGoogle ScholarPubMed
Som, M. L., Silver, C. E., Carbajal, P. G. (1966) Surgical approaches to the hypopharynx for benign disease. Archives of Otolaryngology, 83: 222230.CrossRefGoogle Scholar
Spisharny, J. K. (1906) Pharyngotomia suprahyoidea. Zentralblatt fur Chirurgie. 29: 797798.Google Scholar
Trotter, W. (1920) A method of lateral pharyngotomy for the exposure of large growths in the epilaryngeal region. Journal of Laryngology, Rhinology and Otology, 35: 289295.CrossRefGoogle Scholar
Trotter, W. (1928) Operations for malignant disease of the pharynx. British Journal of Surgery, 16: 485495.CrossRefGoogle Scholar
Yarington, C. T., Frazer, J. P. (1966) An approach to the internal laryngocele and other submucosal lesions of the larynx. Annals of Otology, Rhinology and Laryngology, 75: 956960.CrossRefGoogle Scholar