Operative Procedure of Anterior Commissure for Making Type II Thyroplasty Successful

We reviewed the clinical dissection of anterior commissure, and Type II thyroplasty operative procedures. The handling of the anterior commissure is the most important point in this surgery. An inner perichondrium does not exist in the dorsal midline part of the thyroid cartilage, and the collagenous fiber of the anterior commissure tendon combines with the cartilage matrix of the thyroid cartilage at the vocal cord level. At the supraglottic level, the thyroepiglottic ligament connects with the thyroid cartilage through the collagenous fiber of the anterior commissure tendon which extends to the supraglottics. In order to maintain a moderate glottis split with certainty and permanence, don’t exfoliate this tendon from the thyroid cartilage. It is necessary to split the tendon and to spread the glottis while the tendon is joined with the cartilage. For this purpose, a special spreader was made.