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Laser Cordectomy

T1 Glottic Carcinoma

1. Preoperative view. Decortication of the vocal cord has preceded. 2. Insertion of pledget to protect the cuff.
3. Delineating for the removal of the left false vocal cord. 4. Beginning transection.
5. Continuing the removal of the false cord. 6. Completion of the removal of the false vocal cord. The upper surface of the true cord is clearly visible.
7. Beginning the removal of a part of the right false cord. 8. Completion of the removal in the right side also. The glottis under total control.
9. Transection at the middle of the vocal cord. The tumor extended from the anterior commissure to the vocal process of the arytenoid. 10. Delineation of the removal including the anterior third of the right vocal cord.
11. Commencing the removal of the anterior part of the glottis having the thyroid cartilage as border. 12. During the dissection, a large vessel may be encountered. The bleeder is located by the suction .
13. grasped by the forceps and cauterized. 14. Continuing the laser dissection. The inner surface of the thyroid cartilage is seen.
15. The perichondrium is gradually cut and detached. 16. Continuing elevating the specimen by detaching the perichondrium.
17. Detachment reaches the inferior border of the thyroid cartilage. 18. Transection along the attachment of the specimen to the cricothyroid membrane.
19. View after removal of the anterior specimen. 20. Moving the endotracheal tube with the laryngoscope.
21. Reinsertion of pledget to protect the cuff. 22. Delineation for the removal of the posterior part of the cord, through the vocal process of the arytenoid cartilage.
23. Beginning dissection. 24. Enough bleeders are encountered and treated with cauterization.
25. Completion of removal with scissors. 26. The final view of the posterior glottis.
27. View of the anterior glottis. The denuded thyroid cartilage is seen, as well as the area of the cricothyroid membrane and inside the circle the protrusion of the cricoid cartilage. 28. A large piece of cotton to clean the larynx.