Note: For a much larger gallery of photos, see our new standalone educational website, Bastian Medical Media for Laryngology.
Initial view with white sphere (cyst) shining through upper surface of left vocal fold.
After injection of lidocaine for hydrodissection (Bouchayer).
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).
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.
Scissors are used to release the cyst from filmy attachments, precisely at its margin.
The flap is released and returned to its original position; the incipient sulcus is still seen.
Retraction of the flap reveals the gossamer nature of the still-intact overlying mucosa.