title: Suprahyoid and inferior constrictor release for laryngeal lowering.
abstract: OBJECTIVE
  To quantify accurately the suprahyoid and inferior constrictor releases, which are used to decrease tension across a tracheal anastomosis performed after tracheal resection.
  
  
  METHODS
  Intraoperative tension measurements at 0.5-cm intervals of the released laryngotracheal unit were obtained using a spring balance after division of the trachea.
  
  
  METHODS
  A selected series of eight patients undergoing total laryngectomy for laryngeal carcinoma, excluding those with cervical soft-tissue involvement, tongue-base involvement, or a history of radiation therapy to the head and neck.
  
  
  RESULTS
  The suprahyoid and inferior constrictor releases together permit a tension-free, inferior displacement of 2 cm. The suprahyoid release alone permits an inferior laryngotracheal displacement of 3.5 cm without exceeding the critical, anastomotic failure tension of 1700 g. Using the releasing techniques together permits inferior displacement of 4 cm without notably exceeding this critical tension.
  
  
  CONCLUSIONS
  The closure of 2-cm defects without a releasing procedure is supported by this study. Larger defects of 3.5 cm, and occasionally 4 cm, can be closed safely without exceeding the critical tension level using a suprahyoid release. This study supports the use of the suprahyoid and inferior constrictor releases together for the uncomplicated closure of 4-cm defects.
authors.affiliation: Department of Surgery, University of Missouri-Columbia Hospital and Clinics, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Zitsch
authors.forename: J B
authors.initials: JB
authors.lastname: Mullins
authors.forename: J
authors.initials: J
authors.lastname: Templer
authors.forename: W E
authors.initials: WE
authors.lastname: Davis
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D001696:Biomechanical Phenomena; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008875:Middle Aged; D014132:Trachea / Q000502:physiology / Q000601:surgery*