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April 1954

CANCER OF THE LARYNX: Laryngoplasty to Avoid Laryngectomy

Author Affiliations

From the Department of Surgery, University of California Medical Center, Los Angeles, and the General Medical and Surgical Hospital, Veterans Administration Center, Los Angeles.

AMA Arch Otolaryngol. 1954;59(4):395-412. doi:10.1001/archotol.1954.00710050407001

THE SURGICAL principles presented in this paper have made it possible to remove almost the entire larynx and yet retain a normal airway. In all such efforts directed toward the same end—andthere have been many in the past—three technical surgical problems exist, consisting of the need to create a lining, to provide a lumen, and to lend rigidity.

In the technique under discussion, all three have been taken into consideration. For a lining, the external perichondrium of both alae of the thyroid cartilage is preserved and retained in toto, a concept borrowed from St. Clair Thomson's description of hemilaryngectomy. There is precedence for this even in total laryngectomy, since the so-called closed-field method which does not remove this membranous sheet has been an accepted technique for many years. The method of providing a lumen is the old established one of a temporarily retained obturator. The plan for providing rigidity is

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