Laryngeal mini-microflap: a new technique and reassessment of the microflap saga

Vocal fold surgical technique has advanced substantially because of increased knowledge regarding anatomy and physiology of phonation and because of technological improvements. However, many new techniques have been based on anecdote and "common sense," largely because there is no good experimental model for vocal fold surgery since the human is the only species with a vocal ligament. Consequently, our earlier pronouncements require careful reexamination especially as new research adds to our fund of knowledge. Review of the principles and results of laryngeal microflap surgery suggests that there may be important shortcomings in the technique. A new mini-microflap technique appears better, as does limited mucosal resection. This is a preliminary report, and further investigation is needed.