In the past, for larger vocal fold polyps, especially the fish-belly shaped vocal fold polyps with wide base, the surgery was usually performed by supporting laryngoscope or microlaryngoscope, which is painful and poorly tolerated by patients and expensive for general anesthesia. Since the introduction of fiberoptic laryngoscope in our department, combined with the previous experience and experience of indirect laryngoscopic surgery, we adopted the double-entry surgical method in accordance with the principle of minimally invasive surgery to treat 94 cases of broad-based vocal fold polyps, and achieved better results, which are reported below. 1. Materials and methods (1) Clinical data Among the cases of vocal fold polyps treated by the double-entry surgical method between 1994 and 2003, 94 cases of broad-based vocal fold polyps were screened as the criteria of polyps with basal length greater than or equal to 1/3 of the vocal fold length; age 19-71 years; 54 men and 40 women; duration of disease from 2 months to 5 years and 6 months. (2) Surgical method Anesthesia: All patients were operated in the outpatient endoscopy room in a sitting position. 20 minutes before surgery, atropine 0.5 mg was given intramuscularly, and the pharyngeal and nasal cavities were superficially anesthetized with 1% dicaine. After the fiberoptic laryngoscope was introduced into the laryngeal vestibule, 1% dicaine 1 ml was dripped into the vocal fold area through the endoscopic biopsy hole, causing the patient to choke briefly and rest for a few minutes before surgery. Surgery: The fiberoptic laryngoscope is inserted through the nasal cavity of the more open side (ephedrine should be performed in advance to astringent turbinates) to reach the posterior aspect of the uvula, where the root of the tongue and the open laryngeal cavity can be observed completely. If the polyp cannot be completely removed at one time, it can be removed in several times, and the residual micro lesion can be precisely removed with the biopsy forceps inserted from the biopsy hole by the endoscope. The efficacy assessment criteria: cure is the disappearance of hoarseness, examination of the vocal folds without polyps, neat and smooth edges, no adhesions in the vocal folds, and normal activities; effective is the significant improvement of hoarseness, examination of the vocal folds with polyps slightly remaining, no adhesions in the vocal folds, and normal activities; invalid is no improvement of hoarseness. Among 94 cases, 71 cases were cured (cure rate 75.53%), 22 cases were effective (effective rate 23.40%), 2 cases of 94 patients failed to tolerate the first surgery, 1 case was successful in the second surgery after one week, 1 case still failed to tolerate the surgery, and the hoarseness did not improve. 94 cases did not have any complications such as anesthetic drug poisoning, vocal cord adhesions, defects, postoperative bleeding, etc. 3, Discussion Vocal cord polyps are common clinical diseases, and the treatment method is mainly surgery. For example, indirect laryngoscopy can remove large or broad-based polyps, but the precision of operation is poor and easy to damage the vocal folds; fiberoptic laryngoscopy is accurate and fine, but the opening of the supporting biopsy forceps is limited, and it is often impossible to completely remove broad-based or tough polyps; direct laryngoscopy The direct laryngoscope and support laryngoscope are clearly exposed and easy to be operated by both hands, but the operation is more traumatic and has more complications, and the implementation of general anesthesia is expensive. Since the introduction of fiberoptic laryngoscope, our department has gradually developed a minimally invasive double-entry surgical approach to treat vocal fold polyps based on the previous indirect laryngoscopic surgery combined with the advantages of clear exposure of the lesion using endoscopy. Among the treated vocal fold polyps, small lesions or lesions with tips can be completely removed directly under endoscopy using biopsy forceps, while wide based, larger polyps are often not completely removed, and the polyps are effectively and completely removed using indirect laryngeal forceps in different directions. This method differs from the method reported by Yingpeng Han et al [1] in that the fiberoptic laryngoscope is closer to the laryngeal cavity than the rigid tube laryngoscope, and the operative field is clearer; it also differs from the method reported by Hongling Cao in which the indirect laryngoscope is used to operate first and then the fiberoptic endoscope to avoid operating when the indirect laryngoscope is not well observed to prevent damage to the vocal cords. The main difficulty of minimally invasive surgery is how to overcome the gag reflex. Our experience is to fully communicate with patients before surgery to relax their nervousness, to start surface anesthesia gently to reduce the stimulation of the pharynx, to start with a small dose of spray, and to observe whether the patient has any uncomfortable reaction. When the patient chokes and coughs, it means that the anesthesia drug has entered the laryngeal cavity, and then the fiberoptic laryngoscope can be introduced. During surgery, the laryngeal forceps should be entered gently, especially for lesions at the anterior union, attention should be paid to the angle of the laryngeal forceps to avoid forcefully pulling the epiglottis surface or compressing the tongue root, which can effectively reduce the occurrence of gag reflex. 1% dicaine surface anesthesia takes effect after 5-7 minutes, and the maintenance time is short, usually about 5 minutes, so the operator should be skilled in operation, after the validity of anesthesia, the patient generally cannot tolerate the surgery and will have After the expiration date of anesthesia, patients generally cannot tolerate the surgery and will have reactions such as choking or nausea, and cannot operate. This minimally invasive surgery is performed under superficial anesthesia, and atropine 0.5 mg is given intramuscularly 30 minutes before surgery, with the aim of reducing intraoperative secretion of glands in the pharyngeal cavity. Although the secretion will become viscous, it can still expose the laryngeal vestibule well and facilitate the surgery while ensuring the suction tube is unobstructed. Compared with the introduction of fiberoptic laryngoscope from the oral cavity, the introduction from the nasal cavity is less affected by the movement of the tongue, and the image seen from the monitor is more stable intraoperatively. Only patients with abnormal nasal structure and difficulty in introduction are introduced from the oral cavity. In addition, after introducing the endoscope from the oral cavity, it seems less convenient to put the indirect laryngeal forceps from the oral cavity, which affects the surgical operation. In the last decade, the endoscope has evolved from a fiberoptic laryngoscope to an electronic laryngoscope with electronic imaging technology, the electric nebulizer on the integrated treatment table has replaced the manual nebulizer, and the surgical technique and proficiency have been improved and enhanced in practice, making this minimally invasive surgical approach worthy of wider use in laryngeal surgery.