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Proposal of landmarks for clamping neurovascular elements during endoscopic surgery of the supraglottic region

Lookup NU author(s): Professor Stephen McHanwell


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Background Bleeding within the supraglottic region can be a lethal complication after CO2 laser microsurgery. Our aim was to propose endoluminal anatomical landmarks to locate the superior laryngeal vessels resulting in a safer microsurgery. Methods Endoluminal dissections were made in 22 larynges without laryngeal disease. Results The neurovascular structures were in the superior third of a triangle defined by the vocal process, the anterior commissure, and the epiglottic attachment of the aryepiglottic fold. They overlapped in 4 different ways: pattern I (70.4%): superior laryngeal vein (SLV), superior laryngeal artery (SLA), and internal laryngeal nerve (ILN); pattern II (13.6%): SLA, SLV, ILN; pattern III (4.6%): SLV, ILN, and SLA; pattern IV (4.6%): SLA, ILN, and SLV. Conclusion Microsurgery in the supraglottic region may be safer if surgeons are aware of the superior third of the above-defined triangle, danger area, where the vascular elements of this region are located. (c) 2012 Wiley Periodicals, Inc. Head Neck, 2013

Publication metadata

Author(s): Souviron R, Maranillo E, Vazquez T, Patel N, McHanwell S, Cobeta I, Scola B, Sanudo J

Publication type: Article

Publication status: Published

Journal: Head & Neck

Year: 2013

Volume: 35

Issue: 1

Pages: 57-60

Print publication date: 06/02/2012

ISSN (print): 1043-3074

ISSN (electronic): 1097-0347

Publisher: John Wiley & Sons, Inc.


DOI: 10.1002/hed.22902


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Funder referenceFunder name
F.I.S. 07/0451Spanish Government
F.I.S. 10/02721Spanish Government