喉頭垂直部切における前連合部の処理について—前連合部反転法

A NEW TECHNIQUE EMPLOYING VERTICAL PARTIAL LARYNGECTOMY FOR REMOVAL OF CANCER INVADING THE ANTERIOR COMMISURE

　腫瘍が明らかに前連合に及んでいない症例では喉頭正中断によつて安全に垂直部分切除術を行なうことができるが，本小文ではそのような症例を除外し，腫瘍が前連合に及んでいるか，あるいはその疑いのある症例において，前連合部を明視下に置いて，健康組織を必要かつ最小限度につけたsafe marginにおいて腫瘍を切除する一法を述べたいと思う。

　A technique is presented whereby a much better view of the anterior commisure of the larynx,the Achillis tendon, in coping with during vertical partial laryngectomy.

　This method, in short, is to remove the tumor-bearing mass of the larynx by making a start from an incision on the lower margin of the mass followed by incision on the posterior and superior margin instead of the initial incision on the midline of the soft tissue of the larynx which has been traditionally used.

　The tumor-bearing mass is, by these manners, turned over towards the contralateral side of the larynx as a continuation of the less involved vocal cord and false vocal cord.

　We believe that by this way it is much easier to be sure of an adequate removal with a safe margin of normal tissues around the growth under direct vision.