MDL - Carcinoma
Considerations
For Dr. Jiang and Dr. Durr
See Chapter 10 and Chapter 13 and Chapter 30 of the book Operative Techniques in Laryngology (2008) by Rosen and Simpson
Anatomy
True vocal fold
5 histologic layers
Epithelium
Superficial lamina propia
Intermediate lamina propia
Deep lamina propia
Thyroarytenoid muscle (aka vocalis muscle)
Functional comparison, according to 2005: Surgical procedures for voice restoration
Indicated for T1a SCC
Must be able see the entire lesion
Know the European classification of cordectomy
Preparation
For the basic preparation, see the Micro-Direct Laryngoscopy - basic page
Tongue blade
27 gauge needles
May need 70 degree endoscope
CO2 laser, 4 watts, ultra-pulse
Procedure
Remove the lesion using the CO2 laser
Keep the specimen oriented during and upon excision
Once excised, orient on the table using the tongue blade and needle
Photograph before and after excision
Post-op
No voice rest indicated according to Rosen text
For Dr. Durr, use the the University of Texas Voice Rest protocol here
See the smartphrase by J Gilde: JEGPIVOICERESTPO