Diagram of<unk>  procedure, lateral view. * Local anesthesia is preferred for<unk>  so that the voice can be tested during the procedure. * A horizontal skin incision is made at the inferior border of the thyroid cartilage. * A window is cut in the thyroid cartilage for a suture to be passed through later in the procedure. * The strap muscles, pharynx, and larynx are dissected to expose the muscular process of the<unk>  cartilage. * A permanent suture is passed through the muscular process. * A tunnel is made in the thyroid cartilage and one end of the suture is passed through it. * The suture is tied and secured to the window made in the thyroid cartilage. * The vocal cords are observed endoscopically to ensure proper rotation of the<unk> . * The patient is asked to phonate to evaluate voice quality and the potential need for a concurrent thyroplasty.
Arytenoid adduction
Tongue thrust
Sinus lift
Cramp
Adams clasp
Arm recoil
Pressure of speech
Forehead lift