Phonomicrosurgery I: principles and equipment.

Phonomicrosurgery arose from 19th century endolaryngeal surgery, which was done through a natural passage and was one of the earliest forms of minimally invasive procedural interventions. The evolution and growth of laryngology as a specialty is inextricably connected to the development of endoscopic laryngeal surgery. Phonomicrosurgical techniques have evolved in the last decade of the 20th century as a group of procedures that are guided by physiologic principles of vocal fold oscillation so as to improve vocal outcome. The anatomic premise of these techniques is to maximally preserve the vocal fold's layered microstructure, epithelium, and lamina propria. Phonomicrosurgery has acquired increasing importance because a dependable voice has become a necessity in our communication-based society.