LAEYNGOTOMY ARYTENECTOMY. 471 



arytenoid (see Pig. 413), the instrument being then carried into 

 the larynx on the median line, from before backward to the cri- 

 coid, and thence from within outward and from below upward, as 

 far as the insertion of the yocal cord. To save the mucous mem- 



Fig. il3.— 3d Step, a, Incision of the Mucous Membrane along tlie Superior and Pos- 

 terior Borders of the Arytenoid. 



brane, the incision may be made at some distance from the bor- 

 ders of the cartUage, but the division of the membrane must be 

 complete. 



(b) Section of the Yocal Cord ; Dissection of the Cartilage 

 on its Inferior and Anterior Borders and External Face. — With 

 long, sharp, straight scissors, the vocal cord is excised at its in- 

 sertion upon the arytenoid (see Fig. 414). The cartUage is then, 

 by smaU nips of the scissors, made from behind forward, dis- 

 sected in dividing the mucous membrane along its inferior bor- 

 der, and the muscular fibres of the crico-arytenoid and thyro-ary- 

 tenoid, inserted on its external face (Fig. 415); the mucous mem- 

 brane, which covers the anterior border, being divided from above 



