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Thick or Thin

Question: A patient undergoes resection of a T1a squamous cell carcinoma extending along the length of the right true vocal fold. Intraoperatively it is determined that the lesion is deep enough to require removal of the entire superficial lamina propria (SLP) to achieve a margin-negative resection. Which of the following likely offers the best voice outcome?

a) Resect entire vocal ligament and preserve maximum amount of vocalis muscle

b) Resect SLP and preserve maximum amount of vocal ligament

c) Resect SLP and perform medialization laryngoplasty

d) Resect SLP and perform split-thickness resection of the vocal ligament

[Answer will be posted with next week's new question]

Answer to last week's question, “Fun Guy” (March 16, 2020)

B - Chronic invasive fungal sinusitis.