Proposal of landmarks for clamping neurovascular elements during endoscopic surgery of the supraglottic region
Article first published online: 6 FEB 2012
Copyright © 2012 Wiley Periodicals, Inc.
Head & Neck
Volume 35, Issue 1, pages 57–60, January 2013
How to Cite
Souvirón, R., Maranillo, E., Vázquez, T., Patel, N., McHanwell, S., Cobeta, I., Scola, B. and Sañudo, J. (2013), Proposal of landmarks for clamping neurovascular elements during endoscopic surgery of the supraglottic region. Head Neck, 35: 57–60. doi: 10.1002/hed.22902
- Issue published online: 15 DEC 2012
- Article first published online: 6 FEB 2012
- Manuscript Accepted: 2 NOV 2011
- Spanish Government. Grant Numbers: F.I.S. 07/0451, F.I.S. 10/02721
- superior laryngeal artery;
- paraglottic space;
- internal laryngeal nerve;
- CO2 laser microsurgery
Bleeding within the supraglottic region can be a lethal complication after CO2 laser microsurgery. Our aim was to propose endoluminal anatomical landmarks to locate the superior laryngeal vessels resulting in a safer microsurgery.
Endoluminal dissections were made in 22 larynges without laryngeal disease.
The neurovascular structures were in the superior third of a triangle defined by the vocal process, the anterior commissure, and the epiglottic attachment of the aryepiglottic fold. They overlapped in 4 different ways: pattern I (70.4%): superior laryngeal vein (SLV), superior laryngeal artery (SLA), and internal laryngeal nerve (ILN); pattern II (13.6%): SLA, SLV, ILN; pattern III (4.6%): SLV, ILN, and SLA; pattern IV (4.6%): SLA, ILN, and SLV.
Microsurgery in the supraglottic region may be safer if surgeons are aware of the superior third of the above-defined triangle, “danger area”, where the vascular elements of this region are located. © 2012 Wiley Periodicals, Inc. Head Neck, 2013