Surgical procedures
A complete preoperative examination was performed prior to surgery to exclude systemic diseases. This included chest radiography, an electrocardiogram, hepatic and renal function tests, and other routine clinical tests. The ALH patients in the chemotherapy group were treated with bleomycin (1.5 million units/bottle) (Tianjin Tai-He Pharmaceutical, Tianjin, China). However, the ALH patients in the ALH excision group were treated using many methods (including CO2 laser excision, holmium laser excision, and excision using cold micro surgical instruments).
Resection of ALHs located on thearytenoids under a microlaryngoscope using cold micro surgical instruments
After general anesthesia, ALH patients were placed in a supine position, and a direct laryngoscope was used to expose the lesions. The microscope was then used to examine the ALHs. The ALHs were located on the arytenoids. After the base of the ALHs was explored, micro laryngeal forceps were used to elevate the ALHs. Next, laryngeal microscissors were used to separate the base of the ALHs and the normal tissue. Epinephrine-soaked cotton balls were used if the wound was bleeding.