thyroid cartilage lateral incision submucosal tumor resection

Treatment of diseases: congenital subglottic stenosis Indication Submucosal tumor resection for thyroid cartilage is suitable for submucosal benign tumors on the glottis. Surgical procedure Incision 1 transverse incision: a horizontal incision along the middle of the thyroid cartilage is about 5-6 cm long. 2 oblique incision: a 6 cm oblique incision was made along the anterior border of the sternocleidomastoid muscle on the tumor side. Separate skin, subcutaneous tissue, and platysma. 2. Tracheotomy If the tracheotomy is not performed before surgery, the tracheotomy can be performed from the 3rd to 4th tracheal rings, and the anesthesia cannula can be placed. 3. Reveal one side of the thyroid cartilage board After the skin is separated, the middle part of the sternohyoid muscle of the tumor side is cut transversely and separated to the two ends. The thyroid gland muscle is cut along the upper edge of the thyroid cartilage and separated upward to expose the affected thyroid cartilage plate. 4. Cut the thyroid cartilage The perichondrium was cut from the upper edge of the thyroid cartilage along the upper edge of the thyroid cartilage. The incision cut the perichonal membrane down the posterior edge of the thyroid cartilage plate, and the cartilage membrane was peeled downward to reveal the affected thyroid cartilage plate. 5. Excision of thyroid cartilage plate Separate the inner perichondrium membrane of the exposed thyroid cartilage plate, and take care not to damage the superior laryngeal nerve when separating the perichondrium. The thyroid cartilage plate half is then removed. 6. Resection of the tumor After the thyroid cartilage plate is removed, the tumor on the glottis is revealed, and the tumor is carefully removed from the mucosa. Do not pierce the mucosa. 7. Close the pharynx After the tumor is resected, the mucosa on the surface of the tumor is pulled outward and sutured with the thyroid cartilage membrane, and then the perichondrium of the upper edge of the thyroid cartilage is sutured with the thyroplasty to close the pharyngeal cavity. 8. Suture incision The ruptured ends of the sternohyoid muscle and the sternohyoid muscle were sutured by the gut. Wash with saline and let the flow strips. Subcutaneous tissue and skin are layered by thin wire. 9. Remove the anesthesia cannula and place the tracheal cannula. 10. Extracting tube casing After the wound is completely healed, the indirect laryngoscopy has no tumor obstruction in the laryngeal cavity, and the tracheal cannula can be blocked for 2 to 3 days. If the breathing is smooth, the tracheal tube can be pulled out. Cover the wound with Vaseline gauze, change dressing daily, and heal itself after 1 week. If it is not cured, it can be repaired. complication Wound bleeding If the laryngeal mucosa is poorly hemostasis, or the laryngeal artery injury is not ligated, blood may be delivered, and the blood should be properly stopped during the operation. If the bleeding is serious, the surgery cavity should be opened to stop bleeding. 2. Incision infection Laryngeal surgery and the respiratory tract are very easy to infect, pay attention to aseptic operation during surgery, and carefully change the medicine after surgery to avoid infection. 3. Pulmonary complications Intraoperative blood flow into the lower respiratory tract, and postoperative suction is not timely, can lead to pulmonary complications. Intraoperative anesthesia intubation balloon should be inflated, gauze around the intubation, often sucking after surgery, systemic application of antibiotics to prevent pulmonary complications. 4. When the thyroid cartilage lateral incision separates the bilateral perichondrium, it is easy to damage the superior laryngeal nerve. The anatomical signs should be identified when separating and carefully separated to avoid damage to the superior laryngeal nerve.