LARYNGOTOMY. 
207 
the arytenoid, and the cartilage separated from the muscles covering 
its outer surface with the fingers, scissors, or scalpel. By keeping 
close to the cartilage the bleeding is slight. The mucous mem¬ 
brane is then divided from the anterior upper border of the arytenoid 
cartilage, care being taken to spare it as much as possible. Bor this 
purpose the index finger of the left hand is introduced into the sacculus 
Fig. 99.— 
Scalpel for 
resection of 
arytenoid. 
- s± 
k~ R.S, B. 
f L.R.U 
um 
Fig. 100.— Course of incision. 
Horse’s larynx (seen from below). Sk., Thyroid cartilage ; 
E.S.B., cricothyroid ligament; S.b., vocal cord ; S.bf., vocal 
process of arytenoid ; II. k., cricoid cartilage ; L.G.k., left 
arytenoid; L.R. (I., II., III.), fh'st, second, and third 
rings of the trachea. 
laryngis, and the membrane cut through with scissors close to the 
border of the cartilage. In this procedure one is specially guided by the 
indications afforded by the left hand. The arytenoid cartilage is now 
cut through with the scalpel, as near as possible to its articular surface, 
so that only a thin fragment of cartilage remains. This portion of the 
operation is the most difficult; especially in old horses, where the 
articulatory portion of the cartilage is often ossified. The knife must 
be inserted within and below, and the cut made upwards and outwards. 
As considerable force is often necessary in dividing the cartilage, it 
requires care to prevent the knife slipping off unexpectedly. Although 
frequently performing the operation, Moller never, however, had an 
accident of this kind. As soon as the arytenoid cartilage is divided it 
may be easily freed from the neighbouring soft parts, and removed with 
the help of a long and sharply-bent pair of scissors. In this case, also, 
