9783540258063

Table of Contents


PART A	CLINICAL EVALUATION OF LARYNGEAL DISORDERS
1	Anatomy and Physiology of the Larynx	3
1.1	Anatomy	3
1.1.1	Laryngeal Cartilages	3
1.1.1.1	Thyroid	3
1.1.1.2	Cricoid	3
1.1.1.3	Arytenoid	3
1.1.1.4	Accessory Cartilages: Cuneiform and Corniculate	3
1.1.1.5	Epiglottis	4
1.1.2	Laryngeal Joints	4
1.1.2.1	Cricothyroid Joint	4
1.1.2.2	Cricoarytenoid Joint	4
1.1.3	Laryngeal Musculature	4
1.1.3.1	Intrinsic Laryngeal Muscles	4
1.1.3.2	Extrinsic Laryngeal Muscles	5
1.1.4	Fibroelastic Tissue of the Larynx	5
1.1.4.1	Quadrangular Membrane	5
1.1.4.2	Conus Elasticus	5
1.1.5	Microanatomy of the Vocal Fold	6
1.1.6	Vasculature	6
1.1.7	Innervation	6
1.2	Physiology	7
1.2.1	Major Laryngeal Functions: Lower Airway Protection, Respiration, and Phonation	7
1.2.1.1	Phonation	7
	Key Points	8
	Selected Bibliography	8
2	Principles of Clinical Evaluation for Voice Disorders	9
2.1	Fundamental and Related Chapters	9
2.2	Introduction	9
2.3	Gathering a Patient History	9
2.4	History of Present Illness	9
2.5	Past Medical History	10
2.6	Past Surgical History	11
2.7	Social History	11
2.8	Occupational History	11
2.9	Listening to the Voice	11
2.10	Perceptual Analysis	12
2.11	Quality-of-Life Questionnaires	12
2.12	Professional Speaking/Singing Voice	12
	Key Points	14
	Selected Bibliography	14
3	Videostroboscopy and Dynamic Voice Evaluation with Flexible Laryngoscopy	17
3.1	Fundamental and Related Chapters	17
3.2	Introduction	17
3.3	Surgical Indications and Contraindications	17
3.4	Dynamic Voice Assessment with Flexible Laryngoscopy	18
3.4.1	Nasopharynx	19
3.4.2	Base of Tongue	19
3.4.3	Larynx (Global)	19
3.4.4	Vocal Fold (Focal)	19
3.5	Recording of Laryngeal Examination	19
	Key Points	20
	Selected Bibliography	20
4	Pathological Conditions of the Vocal Fold	21
4.1	Fundamental and Related Chapters	21
4.2	Introduction	21
4.3	Epithelial Pathology of the Vocal Folds	21
4.3.1	Recurrent Respiratory Papillomatosis of the Larynx	21
4.3.2	Leukoplakia of the Vocal Fold	21
4.3.3	Dysplasia-Carcinoma in Situ of the Vocal Folds	21
4.3.4	Carcinoma of the Vocal Fold	22
4.4	Benign Diseases of the Vocal Fold Lamina Propria	23
4.4.1	Overview of Midmembranous Vocal Fold Lesions	23
4.4.2	Approach to Midmembranous Vocal Fold Lesions	23
4.4.3	Vocal Fold Nodules	23
4.4.4	Vocal Fold Cyst (Subepithelial)	23
4.4.5	Vocal Fold Cyst (Ligament)	24
4.4.6	Vocal Fold Polyp	24
4.4.7	Fibrous Mass (Subepithelial)	24
4.4.8	Fibrous Mass (Ligament)	24
4.4.9	Reactive Lesion	25
4.5	Miscellaneous Disorders of the Vocal Fold	25
4.5.1	Polypoid Corditis (Reinke�s Edema)	25
4.5.2	Vocal Fold Granuloma	25
4.5.3	Rheumatologic Lesions of the Vocal Folds	26
4.5.4	Vascular Lesions of the Vocal Folds	26
4.5.5	Vocal Fold Scar and Sulcus Vocalis	27
	Key Points	27
	Selected Bibliography	27
5	Glottic Insufficiency: Vocal Fold Paralysis, Paresis, and Atrophy	29
5.1	Introduction	29
5.2	Unilateral Vocal Fold Paralysis	29
5.2.1	Etiology	29
5.3	Surgical Indications and Contraindications	30
5.3.1	Vocal Quality and Swallowing	30
5.4	Unilateral Vocal Fold Paralysis: Physical Examination	31
5.4.1	General	31
5.4.2	Laryngeal	31
5.5	Unilateral Vocal Fold Paralysis: Workup	32
5.5.1	Serology	32
5.5.2	Imaging Studies	32
5.6	Unilateral Vocal Fold Paralysis: Treatment	32
5.7	Unilateral/Bilateral Vocal Fold Paresis	33
5.7.1	Etiology	33
5.7.2	History	33
5.7.3	Physical Examination	33
5.7.4	Diagnostic Workup	33
5.7.5	Treatment	33
5.8	Presbylaryngis/Age-Related Changes in the Larynx	34
5.8.1	General Considerations	34
5.8.2	Etiology, History, and Physical Findings	34
5.8.3	Workup	34
	Key Points	34
	Selected Bibliography	35
6	Glottic and Subglottic Stenosis: Evaluation and Surgical Planning	37
6.1	Fundamental and Related Chapters	37
6.2	Introduction	37
6.3	Etiology of Glottic and Subglottic (Laryngotracheal) Narrowing	37
6.3.1	Common Clinical Conditions and Associated Risk Factors	37
6.4	Glottic and Subglottic Stenosis: History	38
6.4.1	Symptoms/Time Course	38
6.4.2	Medical Comorbidities	38
6.5	Glottic and Subglottic Stenosis: Physical Examination	38
6.5.1	Local Anesthesia Techniques for Examination	38
6.5.2	Documentation of Examination	38
6.5.2.1	Flexible Laryngoscopy/Tracheoscopy Protocol	39
6.6	Additional Studies for the Evaluation of Glottic/Subglottic Stenosis	40
6.6.1	Voice Evaluation (VHI-10, Audio Recording)	40
6.6.2	Air-Flow Measures	40
6.6.3	Radiographic Studies	40
6.6.4	Laboratory Testing	40
6.7	Glottic and Subglottic Stenosis: Surgical Planning	41
6.7.1	Corrective Surgical Procedures for Glottic/Subglottic Stenosis	41
6.7.2	Criteria for Endoscopic Treatment for Subglottic Stenosis	41
6.7.3	Criteria for T-Tube Stenting for Subglottic Stenosis	42
6.7.4	Criteria for External Treatment of Glottic/Subglottic Stenosis	42
	Key Points	42
	Selected Bibliography	42
7	Nonsurgical Treatment of Voice Disorders	43
7.1	Fundamental and Related Chapters	43
7.2	Introduction	43
7.3	Surgical Indications and Contraindications	43
7.4	Vocal Fold Granuloma	43
7.5	Infectious and Inflammatory Disorders	44
7.6	Neurologic Disorders	45
7.6.1	Spasmodic Dysphonia	45
7.6.2	Essential Tremor	45
7.6.3	Parkinson�s Disease	45
7.6.4	Muscle Tension Dysphonia	45
7.6.5	Paradoxical Vocal Fold Motion Disorder	46
7.6.6	Postviral Vagal Neuropathy	46
7.7	Allergy and Voice Disorders	46
7.8	Medications and their Effects on Voice	46
7.9	Vocal Hygiene	47
7.10	Role of the Speech�Language Pathologist in Voice Therapy	47
	Key Points	48
	Selected Bibliography	48
8	Timing, Planning, and Decision Making in Phonosurgery	49
8.1	Fundamental and Related Chapters	49
8.2	Key Components to Successful Care of Patients with Voice Disorders	49
8.3	Surgical Indications and Contraindications	49
8.3.1	Timing of Phonomicrosurgery	49
8.3.2	Preoperative Considerations for Phonomicrosurgery	49
8.4	Decision Making in Phonosurgery	50
8.5	Informed Consent Regarding Phonosurgery	51
	Key Points	51
	Selected Bibliography	51
9	Anesthesia and Airway Management for Laryngeal Surgery	53
9.1	Fundamental and Related Chapters	53
9.2	Equipment	53
9.3	Surgical Indications and Contraindications	53
9.4	Principles of Airway Management: Subgloltic and Tracheal Stenosis	54
9.5	Special Circumstances: Difficult Exposure of the Larynx	55
9.6	Anesthesia for Laryngeal Framework Surgery	58
	Key Points	58
	Selected Bibliography	58
PART B	PHONOMICROSURGERY FOR BENIGN LARYNGEAL PATHOLOGY
I	FUNDAMENTALS OF PHONOMICROSURGERY
10	Principles of Phonomicrosurgery	63
10.1	Fundamental and Related Chapters	63
10.2	Introduction	63
10.3	Surgical Indications and Contraindications	63
10.4	Equipment for Phonomicrosurgery	65
10.5	Phonomicrosurgery Procedures, Techniques, and Methods	67
10.5.1	Anesthesia	67
10.5.2	Patient Position	68
10.5.3	Laryngoscope Placement	68
10.5.4	Suspension Device	70
10.5.5	External Counter-Pressure	71
10.5.6	Telescopic Evaluation of Vocal Fold Pathology	71
10.5.7	Operating Microscope and Surgeon Ergonomics	72
10.5.8	Microflap Approach to Submucosal Pathology	73
10.6	Postoperative Care and Complications	75
	Key Points	75
	Selected Bibliography	75
11	Perioperative Care for Phonomicrosurgery	77
11.1	Fundamental and Related Chapters	77
11.2	Timing of Phonomicrosurgery	77
11.3	Surgical Indications and Contraindications	77
11.4	Considerations for the Day of Phonomicrosurgery	78
11.5	Postoperative Voice Rest	78
11.6	Postoperative Voice Care	78
11.7	Intralaryngeal Steroid Injection to Soften Postoperative Scar in the Vocal Fold	78
	Key Points	79
	Selected Bibliography	79
12	Management and Prevention of Complications Related to Phonomicrosurgery	81
12.1	Fundamental and Related Chapters	81
12.2	Overview of Management and Prevention of Complications Related to Phonomicrosurgery	81
12.3	Surgical Indications and Contraindications	81
12.4	Postoperative Dysphonia	81
12.5	Medical Complications Associated with Phonomicrosurgery	82
	Key Points	82
	Selected Bibliography	83
13	Principles of Laser Microlaryngoscopy	85
13.1	Fundamental and Related Chapters	85
13.2	Laser Physics	85
13.2.1	Wavelength	85
13.2.2	Tissue Interaction	85
13.2.3	Delivery Systems	85
13.2.4	Types of Laser	86
13.3	Surgical Indications and Contraindications	86
13.4	Equipment: Laser Microlaryngoscopy Setup	87
13.5	CO₂ Laser Safety Guidelines	87
13.5.1	General Guidelines (Fig. 13.1)	87
13.5.2	CO₂ Laser Settings	88
13.5.3	Safety Protocol	88
13.6	Surgical Principles	88
13.6.1	Smoke Evacuation	88
13.6.2	Protecting Surrounding Tissue from Laser Damage	88
13.6.3	Maintenance of a Clean Surgical Field	88
13.7	Complications and their Treatments	89
13.7.1	Laser Fire	89
13.7.2	Tracheal Perforation	89
	Key Points	89
	Selected Bibliography	89
14	Principles of Vocal Fold Augmentation	91
14.1	Fundamental and Related Chapters	91
14.2	Vocal Fold Augmentation: Advantages, Disadvantages, and Clinical Utility	91
14.3	Surgical Indications and Contraindications	91
14.4	Characteristics of Vocal Fold Augmentation Materials	92
14.4.1	Overview	92
14.4.2	Categories of Vocal Fold Augmentation Materials	92
14.4.3	Description of Vocal Fold Augmentation Materials Characteristics	92
14.5	General Principles of Vocal Fold Augmentation	94
	Key Points	95
	Selected Bibliography	96
II	PHONOMICROSURGICAL VOICE PROCEDURES
15	Vocal Fold Polyp	99
15.1	Fundamental and Related Chapters	99
15.2	Disease Characteristics and Differential Diagnosis	99
15.3	Surgical Indications and Contraindications	99
15.4	Surgical Equipment	99
15.5	Surgical Procedures	100
15.6	Postoperative Care/Complications	103
	Key Points	103
	Selected Bibliography	103
16	Vocal Fold Nodules	105
16.1	Fundamental and Related Chapters	105
16.2	Disease Characteristics and Differential Diagnosis	105
16.3	Surgical Indications and Contraindications	105
16.4	Surgical Equipment	105
16.5	Surgical Procedure	106
16.6	Postoperative Care and Complications	107
	Key Points	107
	Selected Bibliography	107
17	Vocal Fold Cyst and Vocal Fold Fibrous Mass	109
17.1	Fundamental and Related Chapters	109
17.2	Diagnostic Characteristics and Differential Diagnosis	109
17.3	Surgical Indications and Contraindications	109
17.4	Surgical Equipment	109
17.5	Surgical Procedure	109
17.6	Postoperative Care and Complications	111
	Key Points	112
	Selected Bibliography	112
18	Polypoid Corditis	113
18.1	Fundamental and Related Chapters	113
18.2	Disease Characteristics	113
18.3	Surgical Indications and Contraindications	113
18.4	Surgical Equipment	114
18.5	Surgical Procedure	114
18.6	Postoperative Care and Complications	116
	Key Points	116
	Selected Bibliography	117
19	Vocal Fold Granuloma	119
19.1	Fundamental and Related Chapters	119
19.2	Disease Characteristics and Differential Diagnosis	119
19.3	Surgical Indications and Contraindications	119
19.4	Surgical Equipment	119
19.5	Surgical Procedure	120
19.6	Postoperative Care and Complications	121
	Key Points	121
	Selected Bibliography	121
20	Vocal Fold Leukoplakia and Hyperkeratosis	123
20.1	Fundamental and Related Chapters	123
20.2	Diagnostic Characteristics and Differential Diagnosis	123
20.3	Surgical Indications and Contraindications	123
20.4	Surgical Equipment	123
20.5	Surgical Procedure	123
20.6	Postoperative Care and Complications	126
	Key Points	126
	Selected Bibliography	127
21	Surgical Treatment of Recurrent Respiratory Papillomatosis of the Larynx	129
21.1	Fundamental and Related Chapters	129
21.2	Disease Characteristics and Differential Diagnosis	129
21.3	Surgical Indications and Contraindications	129
21.4	Surgical Equipment	130
21.5	Surgical Procedure	130
21.6	Postoperative Care and Complications	133
	Key Points	134
	Selected Bibliography	134
22	Surgical Management of Vocal Fold Vascular Lesions	135
22.1	Fundamental and Related Chapters	135
22.2	Diagnostic Characteristics and Differential Diagnosis of Vocal Fold Varicosities	135
22.3	Surgical Indications and Contraindications	136
22.4	Surgical Equipment	136
22.5	Surgical Procedure	136
22.6	Postoperative Care and Complications	138
	Key Points	139
	Selected Bibliography	139
23	Vocal Fold Scar and Sulcus Vocalis	141
23.1	Fundamental and Related Chapters	141
23.2	Disease Characteristics and Differential Diagnosis	141
23.3	Surgical Indications and Contraindications	142
23.4	Surgical Equipment	143
23.5	Surgical Procedure	143
23.6	Postoperative Care and Complications	150
	Key Points	150
	Selected Bibliography	150
24	Endoscopic Management of Teflon Granuloma	151
24.1	Fundamental and Related Chapters	151
24.2	Disease Characteristics and Differential Diagnosis	151
24.3	Surgical Indications and Contraindications	151
24.4	Surgical Equipment	151
24.5	Surgical Procedure	151
24.6	Postoperative Care and Complications	153
	Key Points	153
	Selected Bibliography	154
25	Endoscopic Excision of Saccular Cyst	155
25.1	Fundamental and Related Chapters	155
25.2	Disease Characteristics and Differential Diagnosis	155
25.3	Surgical Indications and Contraindications	156
25.4	Surgical Equipment	156
25.5	Surgical Procedure for Saccular Cyst	156
25.6	Postoperative Care and Complications	157
	Key Points	158
	Selected Bibliography	158
26	Anterior Glottic Web	159
26.1	Fundamental and Related Chapters	159
26.2	Disease Characteristics and Differential Diagnosis	159
26.3	Surgical Indications and Contraindications	159
26.4	Surgical Equipment	159
26.5	Surgical Procedure	160
26.6	Postoperative Care and Complications	164
	Key Points	164
	Selected Bibliography	164
III	LASER MICROLARYNGEAL SURGERY (AIRWAY/NEOPLASTIC CONDITIONS)
27	Bilateral Vocal Fold Paralysis	167
27.1	Fundamental and Related Chapters	167
27.2	Disease Characteristics and Differential Diagnosis	167
27.3	Surgical Indication and Contraindications	167
27.4	Surgical Equipment	168
27.5	Surgical Procedure	168
27.6	Postoperative Care and Complications	171
	Key Points	173
	Selected Bibliography	173
28	Posterior Glottic Stenosis: Endoscopic Approach	175
28.1	Fundamental and Related Chapters	175
28.2	Diagnostic Characteristics and Differential Diagnosis	175
28.3	Surgical Indications and Contraindications	176
28.4	Surgical Equipment	176
28.5	Surgical Procedure	176
28.6	Postoperative Care	179
	Key Points	179
	Selected Bibliography	180
29	Subglottic/Tracheal Stenosis: Laser/Endoscopic Management	181
29.1	Fundamental and Related Chapters	181
29.2	Disease Characteristics and Differential Diagnosis	181
29.3	Surgical Indications and Contraindications	181
29.4	Surgical Equipment	182
29.5	Surgical Procedure	182
29.6	Postoperative Care and Complications	185
29.7	T-Tube Starting of SGS	185
29.8	Surgical Equipment	185
29.9	Surgical Procedure	185
29.10	Postoperative Care	189
29.11	Special Considerations in T-Tube Stenting	189
	Key Points	189
	Selected Bibliography	190
30	Carcinoma of the Vocal Fold	191
30.1	Fundamental and Related Chapters	191
30.2	Disease Characteristics and Differential Diagnosis	191
30.3	Surgical Indications and Contraindications	191
30.4	Surgical Equipment	191
30.5	Surgical Procedure	192
30.6	Postoperative Care and Complications	192
	Key Points	193
	Selected Bibliography	193
IV	LARYNGEAL INJECTION TECHNIQUES
31	Vocal Fold Augmentation via Direct Microlaryngoscopy	197
31.1	Fundamental and Related Chapters	197
31.2	Disease Characteristics	197
31.2.1	Material Selection	197
31.3	Surgical Indications and Contraindications	198
31.4	Surgical Equipment	198
31.5	Surgical Procedure	198
31.5.1	Principles of Deep Vocal Fold Augmentation	198
31.5.2	Vocal Fold Augmentation via Microlaryngoscopy	199
31.5.3	Endoscopic Vocal Fold Injection	199
31.5.4	Lipoinjection of the Vocal Fold	200
31.6	Postoperative Care and Complications	202
	Key Points	203
	Selected Bibliography	203
32	Superficial Vocal Fold Injection	205
32.1	Fundamental and Related Chapters	205
32.2	Disease Characteristics and Differential Diagnosis	205
32.3	Surgical Indications and Contraindications	205
32.4	Surgical Equipment	205
32.5	Surgical Procedure	205
32.6	Postoperative Care and Complications	206
	Key Points	207
	Selected Bibliography	207
33	Peroral Vocal Fold Augmentation in the Clinic Setting	209
33.1	Fundamental and Related Chapters	209
33.2	Disease Characteristics and Differential Diagnosis	209
33.3	Surgical Indications and Contraindications	209
33.3.1	Suitability for Peroral Vocal Fold Augmentation in the Clinic Setting	210
33.4	Surgical Equipment	210
33.5	Surgical Procedure	210
33.6	Postoperative Care and Complications	213
	Key Points	213
	Selected Bibliography	213
34	Percutaneous Vocal Fold Augmentation in the Clinic Setting	215
34.1	Fundamentals and Related Chapters	215
34.2	Disease Characteristics and Differential Diagnosis	215
34.3	Surgical Indications and Contraindications	215
34.3.1	Suitability for Percutaneous Vocal Fold Augmentation in the Clinic Setting	216
34.4	Surgical Equipment	216
34.5	Surgical Procedure	216
34.6	Postoperative Care and Complications	219
	Key Points	219
	Selected Bibliography	220
35	Botulinum Toxin Injection of the Larynx	221
33.1	Fundamental and Related Chapters	221
35.1	Disease Characteristics and Differential Diagnosis	221
35.2.1	Botulinum Toxin Fundamentals	221
35.2.2	Spasmodic Dysphonia and Essential Tremor	221
35.2.3	Different Botulinum Toxin Injection Approaches	222
35.3	Surgical Indications and Contraindications	222
35.4	Equipment	223
35.5	Procedure	223
35.6	Postprocedure Care and Complications	227
	Key Points	227
	Selected Bibliography	227
PART C	LARYNGEAL FRAMEWORK SURGERY
36	Principles of Laryngeal Framework Surgery	231
36.1	Fundamental and Related Chapters	231
36.2	Introduction	231
36.3	Surgical Indications and Contraindications	231
36.3.1	Medialization Laryngoplasty	231
36.3.2	Arytenoid Adduction	231
36.3.3	Cricothyroid Subluxation	232
36.4	Patient Selection for Laryngeal Framework Surgery	232
36.5	Timing of Medialization Laryngoplasty	232
36.6	Technical Notes and Pertinent Anatomic Landmarks for Medialization Laryngoplasty	232
	Key Points	234
	Selected Bibliography	234
37	Perioperative Care for Laryngeal Framework Surgery	235
37.1	Fundamental and Related Chapters	235
37.2	Perioperative Issues in Laryngeal Framework Surgery	235
37.3	Surgical Indications and Contraindications	235
37.4	Suboptimal Results/Surgical Errors	236
37.4.1	Revision Surgery	237
37.5	Long-Term Surgical Issues	239
	Key Points	239
	Selected Bibliography	239
38	Silastic Medialization Laryngoplasty for Unilateral Vocal Fold Paralysis	241
38.1	Fundamental and Related Chapters	241
38.2	Disease Characteristics and Differential Diagnosis	241
38.3	Surgery Indications and Contraindications	241
38.4	Surgical Equipment	241
38.5	Surgical Procedure	242
38.6	Postoperative Care and Complications	250
	Key Points	251
	Selected Bibliography	251
39	GORE-TEX^� Medialization Laryngoplasty	253
39.1	Fundamental and Related Chapters	253
39.2	Disease Characteristics and Differential Diagnosis	253
39.3	Surgical Indications and Contraindications	253
39.4	Surgical Equipment	253
39.5	Surgical Procedure	254
39.6	Postoperative Care and Complications	255
	Key Points	256
	Selected Bibliography	256
40	Arytenoid Adduction	257
40.1	Fundamental and Related Chapters	257
40.2	Fundamentals of Arytenoid Adduction	257
40.3	Surgical Indications and Contraindications	257
40.4	Surgical Equipment	257
40.5	Surgical Procedure	257
40.6	Postoperative Care and Complications	262
	Key Points	262
	Selected Bibliography	262
41	Cricothyroid Subluxation	263
41.1	Fundamental and Related Chapters	263
41.2	Disease Characteristics and Differential Diagnosis	263
41.3	Surgical Indications and Contraindications	263
41.4	Surgical Equipment	263
41.5	Surgical Procedure	263
41.6	Postoperative Care and Complications	264
	Key Points	265
	Bibliography	265
42	Translaryngeal Removal of Teflon Granuloma	267
42.1	Fundamental and Related Chapters	267
42.2	Disease Characteristics and Differential Diagnosis	267
42.3	Surgical Indications and Contraindications	267
42.4	Surgical Equipment	268
42.5	Surgical Procedure	268
42.6	Postoperative Care and Complications	271
	Key Points	271
	Selected Bibliography	271
43	Excision of Combined Laryngocele	273
43.1	Fundamental and Related Chapters	273
43.2	Disease Characteristics and Differential Diagnosis	273
43.2.1	Anatomy and Classification	273
43.2.2	Clinical Presentation and Differential Diagnosis	274
43.3	Surgical Indications and Contraindications	274
43.4	Surgical Equipment	275
43.5	Surgical Procedure	275
43.6	Postoperative Care and Complications	277
	Key Points	277
	Selected Bibliography	277
44	Repair of Laryngeal Fracture	279
44.1	Fundamental and Related Chapters	279
44.2	Disease Characteristics	279
44.3	Surgical Indications and Contraindications	279
44.4	Surgical Equipment	280
44.5	Surgical Procedure	280
44.6	Postoperative Care and Complications	282
	Key Points	282
	Selected Bibliography	282
45	Glottic and Subglottic Stenosis: Laryngotracheal Reconstruction with Grafting	283
45.1	Fundamental and Related Chapters	283
45.2	Disease Characteristics and Differential Diagnosis	283
45.3	Surgical Indications and Contraindications	283
45.4	Surgical Equipment	283
45.5	Surgical Procedure	284
45.6	Postoperative Care and Complications	287
	Key Points	287
	Selected Bibliography	288
46	Glottic and Subglottic Stenosis: Cricotracheal Resection with Primary Anastomosis	289
46.1	Fundamental and Related Chapters	289
46.2	Diagnostic Characteristics for Open Treatment of Subglottic Stenosis	289
46.3	Surgical Indications and Contraindications	289
46.4	Surgical Equipment	289
46.5	Surgical Procedure	289
46.6	Postoperative Management	292
	Key Points	292
	Selected Bibliography	293
47	Tracheal Stenosis:Tracheal Resection with Primary Anastomosis	295
47.1	Fundamental and Related Chapters	295
47.2	Background Information and Diagnosis of Tracheal Stenosis	295
47.3	Surgical Indications and Contraindications	295
47.4	Surgical Equipment	295
47.5	Surgical Procedure	295
47.6	Postoperative Care and Complications	298
	Key Points	298
	Selected Bibliography	298
48	The Gray Minithyrotomy for Vocal Fold Scar/Sulcus Vocalis	299
48.1	Fundamental and Related Chapters	299
48.2	General Considerations	299
48.3	Surgical Indications and Contraindications	299
48.4	Surgical Equipment	299
48.5	Surgical Procedure	299
48.6	Postoperative Care and Complications	303
	Key Points	304
	Selected Bibliography	304
	Subject Index	305