Possible methods of creating a functional neoglottis and of constructing a functionally adequate neolarynx.

The intention of the following report is to present a concept for constructing a substitute glottis (neoglottis). The concept evolved over the years on the basis of anatomic studies and in the course of plastic reconstructions on patients. It is based on pedicled grafting of a voluntarily controllable--and hence trainable--musculature that might be transplanted into the larynx attached to a neurovascular pedicle. A rima glottidis might be imitated that could be opened and closed from a neutral position. During sleep the neoglottis would be in a relaxed, spasm-free position. A sensitive and tactile stimulus response ought to be possible, as should variations of the state of tension of the substitute vocal muscles.