From the Research
In a type 4 cordectomy of the larynx, the posterior cricoarytenoid muscle is respected. This surgical procedure involves the complete removal of the vocal cord, extending to the ventricular fold and including the vocal process of the arytenoid cartilage. The posterior cricoarytenoid muscle, which is the only abductor or respiratory muscle of the larynx, plays a vital role in cases of recurrent palsy and orthotopic transplantation 1. It is essential to preserve this muscle during a type 4 cordectomy to maintain some degree of respiratory function post-operatively. The procedure is typically performed for early glottic cancers that extend beyond the vocal fold but have not invaded deeply into the laryngeal framework or surrounding structures. Some key points to consider in this procedure include:
- The posterior cricoarytenoid muscle nerve supply comes from the anterior division of the recurrent nerve 1
- The number of branches coming from the anterior division varied, ranging from one to six 1
- The preservation of the posterior cricoarytenoid muscle is crucial for maintaining respiratory function and preventing complications such as bilateral vocal cord paralysis 2
- The use of laser arytenoidectomy with posterior cordectomy and laterofixation can be effective in widening the glottis and improving respiratory function in patients with bilateral vocal cord paralysis 2
- Inspiratory muscle training can produce laryngeal abduction in healthy subjects, and training programs may conceivably contribute positively in patients suffering from laryngeal adduction during exercise 3
- Different combinations of muscle activation are used for biomechanical control of vocal fold opening and closing movements during respiratory, airway protection, and speech tasks 4
- The posterior cricoarytenoid muscle opens the laryngeal airway, and abnormalities in the soft tissues of the neck or of the innervation of the larynx, pharynx, and neck muscles may severely interfere with patency of the laryngeal airway 5