Staple-assisted laryngectomy for intractable aspiration

This figure shows the use of an intraluminal light. (A) Note a transnasal endoscope (arrow). We cut the tissue toward the illumination (arrowhead). (B) During suprahyoid dissection, endoscopic transillumination (arrowhead) is a useful guide to identify the appropriate plane of dissection (hyoid bone [arrow]).

This figure shows the laryngofissure approach. (A) A laryngofissure makes it easy to pull the epiglottis (arrow) away from the staple line. A line indicates the staple line. (B) We are pulling the epiglottis (white arrow) with a clamp through a laryngofissure.

Staple-assisted laryngectomy. (A) After stapling, the larynx is sharply transected with a scalpel (arrow). (B) Shows that the larynx has already been removed, and a simultaneous closure of the pharyngeal defect has been completed.