Thyrotomy cartilage augmentation

Treating diseases: laryngeal trauma Indication The thyroid cartilage incision cartilage filling is suitable for: 1. Unilateral vocal cords are obstructed by the vocal cords, and the vocal cords are fixed in the middle or outreach positions, making it difficult to make sound. 2. Loss of intra-Teflon vocal cord injection. 3. Bad voice after laryngeal trauma or laryngeal surgery, not suitable for intra-Teflon vocal injection. Surgical procedure Tracheotomy First, tracheotomy was performed under local anesthesia, an anesthesia cannula was inserted, and general anesthesia was started. 2. Position and incision The supine position, under the shoulder bolster, the head slightly back, the head is in the middle. A transverse incision is made in the middle of the flat thyroid cartilage, which is slightly curved to the anterior border of the sternocleidomastoid muscle. Cut the skin, subcutaneous tissue and platysma. The flap is separated upward to a slightly upper plane of the hyoid bone, and the lower flap is attached to the lower edge of the annular cartilage to fix the flap. 3. Expose the upper part of the thyroid Separate along the thyroid cartilage, the sternohyoid muscle of the operation side is freed, the muscle is cut at the upper edge of the thyroid cartilage, and the thyroplasty and the chondral cartilage are cut at the upper edge of the thyroid cartilage. 4. Intercepting the thyroid cartilage block The thyroid cartilage pterygoid membrane was separated from the thyroid cartilage by the stripper, and the thyroid cartilage pterygoid membrane was separated, so that the upper part of the thyroid cartilage wing was completely freed, and the inner laryngeal nerve branch of the thyroid cartilage wing was protected. The upper part of the thyroid cartilage is cut with a bone saw or a sharp blade, and a small amount should be left behind the thyroid cartilage. 5. Made of triangular cartilage blocks The cut cartilage block is trimmed into a triangle. 6. Place the triangular cartilage block inside the thyroid cartilage The intraoperative cartilage of the thyroid cartilage was separated into the plane of the lower edge of the thyroid cartilage. The cartilage block was placed between the thyroid cartilage and the inner perichondrium, so that it was located on the vocal cord plane, so that the vocal cord process and the nailfold muscle of the cartilage were moved inward. 7. Direct laryngoscopy A direct laryngoscopy confirmed that the vocal cords were moved to the point where they did not affect ventilation. 8. Suture incision The perichondrium is sutured in place to close the perichondrium cavity. Drainage was placed in the wound, the platysma and skin incision were intermittently sutured, and the incision was covered with sterile gauze.