OtoRhinoLaryngology Portal

The Leading Online Gallery of Otolaryngology and Head & Neck Surgery Specialty

OtoRhinoLaryngology Portal Video Collections @

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Epiglottic Haematoma Complicating Suspension Laryngoscopy

Epiglottic Fibrinous Exudate Complicating Manipulation During Laryngoscope Insertion

Fishbone Piercing The Epiglottis

Fishbone piercing the epiglottis (E). white arrow - the proximal part of the fishbone on lingual surface side of epiglottis, yellow arrow - the sharp end of the fishbone on laryngeal surface side of the epiglottis.

Vocal Fold Haemorrhage

Subepithelial vocal fold haemorrhage secondary to intubation injury.  Note subcordal laryngitis due to laryngopharyngeal reflux disease (arrows).  (L - left, R - right, patient is intubated under general anaesthesia) 

Arytenoid Ulcers with Sloughs

Posterolateral ulceration with thick fibrin and inflamed adjacent mucosa.  Vocal fold edema present bilaterally.

 Similar ulceration with covering fibrin (ellipse).  Right vocal fold palsy present.

[RVF - right true vocal fold, LVF - left vocal fold, E - epiglottis]

 Injuries complicating endotracheal intubation.  The true vocal folds were oedematous.  (T - true vocal fold, F - false vocal fold, [+] - granulations, [x] - fibrin exudates, arrows - mucosal ulcerations)

Vocal Fold Detachment from Vocal Process


Supraglottic Stenosis Post-Motor Vehicle Accident

Figure shows narrowing of supraglottic larynx with antero-posterior

approximation of lower laryngeal surface of epiglottis and its petiole region. 

There were bilateral vocal folds immobility due to cricoarytenoid fixation.


Further reading on laryngeal injury:



2.Schaefer SD, Stringer SP. Laryngeal trauma. In: Bailey BJ, Pillsbury HC, Driscoll BP, eds. Head and Neck Surgery: Otolaryngology. Philadelphia, Pa: Lippincott-Raven; 1998:947-56.

3.Schaefer SD, Brown OE. Selective application of CT in the management of laryngeal trauma. Laryngoscope. Nov 1983; 93(11 Pt):1473-5.

Endo-extralaryngeal Needle-Carrier Instrument by Lichtenberger

Glottic Web: Acquired

Figure shows fused anterior free borders of true vocal folds extending to the anterior commissure (rounded rectangle).  Adhesiolysis and temporary glottic keel is indicated to improve the patient's voice quality.  (LVF - left vocal fold, RVF - right vocal fold, A - arytenoid complex, ETT - endotracheal tube)

Glottic stenosis (ellipse) comprising membranous fusion of anterior half of true vocal folds bilaterally.

Glottic Stenosis Post-MVA Secondary to Prolonged Intubation

Dense glottic stenosis extending to anterior subglottis (top left) and after its release by using CO2-laser.  Glottic keel was then placed endoscopically as depicted in below paragraph.  [PC - posterior commissure, arrow - anterior commissure, E - epiglottis, T - true vocal fold, F - false vocal fold, A - arytenoid complex]


Watch video of CO2-laser adhesiolysis and endoscopic laryngeal keel placement @ YouTube

Laryngeal Stent and Keel

Laryngeal anterior commissure stent.



Montgomery laryngeal keel. 

Glottic Stenosis: Intraoperative

Fibrous stenosis involving both the anterior

and posterior commissures.

Endoscopically-inserted custom-made silicone stent

after adhesiolysis and topical application or mitomycin-C


Stomal button being used as a platform for the anchorage of

extralaryngeal suture in endoscopic intralaryngeal keel placement.

Posterior Glottic Stenosis by Scar Formation

Fibrous band of posterior glottic scar.

Triamcinolone acetonide depot infiltration into scar tissue given alone

or in conjunction with surgical lysis as a treatment modality

to modulate fibroblastic formation and healing process. 

Posterior glottis scar (rectangle) complicating inhalational injury of house fire resulting in immobile vocal folds and glottis stenosis necessitating a tracheostomy.

(TVF - true vocal fold, (+) - vocal fold rectractor device flange, A - anterior, R - right, L - left).