The posterior thyroplasty window: anatomical considerations.
OBJECTIVE
Explain surgical technique of performing a posterior thyroplasty window. Describe the internal laryngeal anatomy and structures available through the posterior window approach. Describe posterior window approach.


METHODS
Review of lateral laryngeal anatomy and retrospective review of 125 cases involving a posterior thyroplasty window approach. Review mechanics of stress and stress concentration inherent with partial removal of rigid substance. Describe anatomical considerations and surgical complications.


METHODS
Charts were reviewed and tabulated for surgical complications, efficacy and safety of surgical approach, specific anatomical variations, and variety of surgery available through the posterior window.


RESULTS
Performance of 125 posterior thyroplasty windows revealed no evidence of entry into the piriform sinus. Three thyroid ala fractures ensued, two of the body and one of the inferior cornu. Operations available included arytenoid adduction, arytenoid fixation, lysis of joint adhesions, and access to the posterior cricoarytenoid muscle for botulinum toxin injections.


CONCLUSIONS
The posterior thyroplasty window affords easy, direct access to the internal, posterolateral larynx while preserving the cricothyroid joint, the action of the cricothyroid muscle, and the internal division of the recurrent laryngeal nerve.
Maragos
N E
NE
Mayo Clinic, Rochester, Minnesota 55905, USA.
D001193:Arytenoid Cartilage / Q000033:anatomy & histology / Q000601:surgery; D006801:Humans; D007823:Laryngeal Nerves / Q000503:physiopathology; D007830:Larynx / Q000033:anatomy & histology; D011183:Postoperative Complications; D012009:Recurrent Laryngeal Nerve / Q000033:anatomy & histology*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods*; D013957:Thyroid Cartilage / Q000033:anatomy & histology* / Q000601:surgery*; D014832:Voice Disorders / Q000503:physiopathology / Q000601:surgery