Microscopic support laryngoscope for vocal cord extraversion

The advantages of vocal cord extravasation under microsurgical laryngoscopy are: 1 without removing the sacral cartilage, which is the smallest type of surgery for all exercises that improve breathing; 2 if the procedure is unsuccessful, it does not cause the structure of the larynx. Changes do not affect the success rate of surgical procedures such as chopped cartilage resection. Curing disease: Indication The vocal cord extravasation under microsurgical laryngoscopy is suitable for the dyspnea of the sacral cartilage due to innervation disorders and due to ankylosis of the ankle joint. This procedure can be the preferred method of treatment for such patients. Contraindications Those who have difficulty in exposing the throat under the laryngoscope. Preoperative preparation 1. Take a lateral radiograph of the neck to exclude tracheal stenosis. 2. Pulmonary function test. 3. Direct laryngoscopy or cervical bronchoscopy, and check the activity of the sacral cartilage. 4. Surgical instruments are prepared with 2 19th core with a needle, 2-0 suture, coagulator, button and silicone, support laryngoscope, surgical microscope, microsurgical instrument. Surgical procedure Tracheotomy First, tracheotomy was performed under local anesthesia, and a cannula for tracheal anesthesia was inserted to start general anesthesia. 2. Install the support laryngoscope The patient under the shoulder bolster, the head is later raised, the tooth pad is placed in the mouth to protect the teeth. Pass the laryngoscope through the center of the tongue over the epiglottis, expose the upper area of the glottis and the glottis, install the fixed frame, and fix the laryngoscope. 3. Adjust the operating microscope The objective lens of the surgical microscope is aimed at the laryngoscope, and the structure inside the throat is observed under a microscope. After the image is adjusted, the microscope is fixed. 4. Vocal cord external fixation The incision was made at the outermost edge of the ligament of the larynx at the base of the larynx, and the anterior distance was combined 2 mm before the vocal tract. A segment of the nailfold muscle was cut along the entire length of the incision, and the entire length of the wedge-shaped resection bed was electrocoagulated with a needle-shaped coagulator. The 19th lumbar puncture was used to percutaneously puncture the thyroid cartilage into the larynx, which was placed into the traction line, pulled to the laryngoscope for ligation, and the laryngoscope was relaxed to prevent the vocal cords from twisting. The suture is then ligated outside the skin to allow the vocal cords to move outward. Remove the traction line after 4 weeks by cutting one end of the line, pulling the other end, and pulling the line out