Glottic exposure and entry for vertical partial laryngectomy procedures has
traditionally been through the subglottis. Although this approach is gener
ally satisfactory for the resection of unilateral vocal cord lesions, it ma
y be unsafe in cases in which tumors extend across the midline and/or subgl
ottically. In these instances, we prefer the superior transverse infrahyoid
approach to the glottis, which transacts the petiole of the epiglottis and
reflects the contents of the preepiglottic space posterior and superior. T
his improved visualization of the larynx has permitted precise tumor excisi
on without sacrifice of uninvolved segments of the vocal cords. This proced
ure has been performed 35 times over a 15-year period at our institution fo
r the resection of bilateral glottic tumors, with and without subglottic ex
tension. In none of the cases in which it has been employed was there a pos
itive surgical margin.