title: Reconstruction of the anterior commissure with a free mucosal flap.
abstract: BACKGROUND
  To prevent stenosis and adhesion of the anterior commissure in the laryngeal reconstruction, we devised a technique of relining using a free labial mucosal graft and human fibrin glue.
  
  
  METHODS
  A single large piece of mucosal flap was prepared, folded at the anterior commissure, and sutured onto the raw wound of the larynx from both sides of the posterior glottis. Alternate suturing from both right and left sides was performed anteriorly, and the wound on the laryngeal lumen was fully covered by the mucosal graft. We applied this technique on a patient with laryngeal stenosis and two patients with laryngeal cancer.
  
  
  RESULTS
  Without the use of a stent, we successfully reconstructed the anterior commissure and obtained a good result in voice quality in each case.
  
  
  CONCLUSIONS
  Large mucosal defects including the anterior commissure should be relined to acquire good voice quality. Relining using a free mucosal flap was a useful method since there were no limitations to size and placement. The adhesive property of human fibrin glue was indispensable in this procedure.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, Kyoto University, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kojima
authors.forename: K
authors.initials: K
authors.lastname: Omori
authors.forename: K
authors.initials: K
authors.lastname: Shoji
authors.forename: M
authors.initials: M
authors.lastname: Kanaji
mesh_terms: D000293:Adolescent; D015718:Fibrin Tissue Adhesive; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D007830:Larynx / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000637:transplantation; D013524:Surgical Flaps; D014135:Tracheal Stenosis / Q000601:surgery*; D014833:Voice Quality
chemical_list: D015718:Fibrin Tissue Adhesive