WITH the development of endoscopic instruments, the pharynx, hypopharynx, base of the tongue, upper portion of esophagus and larynx have become reasonably accessible to exploration under direct vision without the necessity for a surgical incision. In the study and treatment of a majority of pathologic conditions in these areas, the endoscopic approach is adequate and furnishes valuable information. However, there are some conditions and circumstances in which a more adequate exposure is either advantageous or absolutely necessary. There have been a number of anatomic approaches to this problem, most of which involve the lateral pharyngeal wall.1 These lateral approaches interrupt at least one important nerve when the opening in the pharynx is of any considerable length. An anterior approach does not destroy any major nerve or vessel and is an easier technical procedure.
Any anterior approach must involve or be related to the hyoid bone. The hyoid bone