Type | Classification | Description |
Type I | Subepithelial cordectomy | – Resection of epithelium through lamina propria but sparing vocal ligament – Diagnostic when vocal fold lesions suspected of premalignant or malignant transformations – Therapeutic if histological results confirm hyperplasia, dysplasia, or carcinoma in situ without signs of microinvasion |
Type II | Subligamental cordectomy | – Resection of epithelium, Reinke’s space, and vocal ligament – Diagnostic for severe leukoplakia when lesion shows clinical signs of neoplastic transformation and stroboscopic examination indicates deeper infiltration, or “vibratory silence” – Therapeutic for microinvasive carcinoma or severe carcinoma-in-situ with possible microinvasion |
Type III | Transmuscular cordectomy | – Resection of epithelium, lamina propria, and part of the vocalis muscle – Indicated for cases of small superficial cancer of the mobile vocal fold |
Type IV | Total or complete cordectomy | – Extends from vocal process to anterior commissure and depth reaches internal perichondrium of thyroid ala – Indicated for cases of T1a cancer, where cancer infiltrates vocal fold |
Type Va | Extended cordectomy encompassing contralateral vocal fold | – Resection includes anterior commissure and either a segment or entire contralateral vocal fold (removes Broyle’s ligament) – Indicated for cancers superficially reaching anterior commissure without infiltrating it and without spreading towards base of epiglottis or towards subglottis |
Type Vb | Extended cordectomy encompassing arytenoid | – Indicated for vocal fold carcinoma involving the vocal process posteriorly but sparing the arytenoid |
Type Vc | Extended cordectomy encompassing the ventricular fold | – Indicated for ventricular cancers or for transglottic cancers that spread from the vocal fold to the ventricle |
Type Vd | Extended cordectomy encompassing the subglottis | – Cord resection can be continued as deep as 1 cm under the glottis in order to expose the cricoid cartilage |
Type VI (from revision) | Encompassing anterior commissure and the anterior part of both vocal folds | – Indicated for cancer originating in anterior commissure with or without extension to one or both vocal folds, without infiltration of the thyroid cartilage |
Contributed by Emily Zhang