Cyst removal (1 of 7) Initial view with white sphere (cyst) shining through upper surface of left vocal fold.
Cyst removal (2 of 7) After injection of lidocaine for hydrodissection (Bouchayer).
Cyst removal (3 of 7) This incision must be ~75% longer than the diameter of the cyst. The most difficult parts of the dissection are typically adherence to the vocal ligament, and to the diaphanous overlying mucosal flap (held here in micro-alligator forceps).
Cyst removal (4 of 7) As is occasionally the case, the cyst has leaked some of its contents, but its outline is still clearly visible, allowing complete and precise removal.
Cyst removal (5 of 7) Scissors are used to release the cyst from filmy attachments, precisely at its margin.
Cyst removal (6 of 7) The flap is released and returned to its original position; the incipient sulcus is still seen.
Cyst removal (7 of 7) Retraction of the flap reveals the gossamer nature of the still-intact overlying mucosa.