. 9, Direct view, recumbent
patient; web postdiphtheric (?) or congenital (?). "Rough voice" since
birth, but larynx never examined until stenosed after diphtheria. Web
removed and larynx eviscerated with punch forceps; recurrence of
stenosis (not of web). Cure by laryngostomy. This view also
illustrates the true depth of the larynx which is often overlooked
because of the misleading flatness of laryngeal illustrations. 10,
Direct laryngoscopic view; postdiphtheric hypertrophic subglottic
stenosis. Cured by galvanocauterization. 11, Direct laryngoscopic
view; postdiphtheric hypertrophic supraglottic stenosis. Forceps
excision; extubation one month later; still well after four years. 12,
Bronchoscopic view of posttracheotomic stenosis following a "plastic
flap" tracheotomy done for acute edema. 13, Direct laryngoscopic view;
anterolateral thymic compression stenosis in a child of eighteen
months. Cured by thymopexy. 14, Indirect laryngoscopic (mirror) view;
laryngostomy rubber tube in position in treatment of post-typhoid
stenosis. 15, Direct view; posttyphoid stenosis after cure by
laryngostomy. Dotted line shows place of excision for clearing out the
anterior commissure to restore the voice. 16, Endoscopic view of
posttracheotomic tracheal stenosis from badly placed incision and
chondrial necrosis. Tracheotomy originally done for influenzal
tracheitis. Cured by tracheostomy.]

_Paralysis_.--Bilateral abductor laryngeal paralysis causes severe
stenosis, and usually tracheotomy is urgently required. In cadaveric
paralysis both cords are in a position midway between abduction and
adduction, and their margins are crescentic, so that sufficient airway
remains. Efforts to produce the cadaveric position of the cords by
division or excision of a portion of the recurrent laryngeal nerves,
have been failures. The operation of _ventriculocordectomy_ consists
in removing a vocal cord and the portion or all of the ventricular
floor by means of a punch forceps introduced through the direct
laryngoscope. Usually it is better to remove only the portion of the
floor anterior to the vocal process of the arytenoid. In some cases
monolateral ventriculocordectomy is sufficient; in most cases,
however, operation on both sides is needed. An interval of two months
between operations is advisable to avoid adhesions. In almost all
cases, ventriculocordectomy will result in a sufficient increase in
the glottic chink for normal respiration. The