Patient (Qinghai Zhang’s 2008, 6, 3): I’m sorry to bother you in the middle of a busy day! Cannot pronounce and speak normally Laboratory tests, vocal cords can be moved; subglottis is visible as enlarged, hyperplastic bulge-like projection (yellowish); red granulation-like tissue is visible in the mucosa of the anterior wall of the subglottis; tracheal mucosa is mulberry-like in height Is it recommended to do laser treatment or open surgery? Which treatment effect will be better and the possibility of recurrence is lower? Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital: The information you provided is incomplete and I cannot give specific advice. Please add the following information: fiberoptic laryngoscope images and biopsy report of the mass (case report). If it is a benign tumor, laser laryngectomy can be considered under laryngeal endoscopy. If it is a malignant tumor, an enlarged resection of the tumor by cervical incision should be performed. Patient: Dr. Ma Lingguo, how are you? Thank you for taking time out of your busy schedule to reply to me. I have a copy of the fiberoptic laryngoscopy report sheet here, which is being sent to you by attachment, because it is in black and white, maybe it is not clear, if I can provide you with a clearer picture of the examination. Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital: These data only indicate that the patient has a surface unsmooth swelling under the voice box. If the disease is long and the swelling grows slowly, it is more likely to be benign, otherwise it is more likely to be malignant. The nature of the mass finally needs to be determined by fiberoptic laryngoscopic biopsy. Further examinations are recommended: 1. enhanced CT examination of the larynx to understand the extent of the mass; 2. biopsy to determine the nature of the mass. If it is a benign tumor, laser resection of the mass under laryngeal endoscopy can be considered. If it is a malignant tumor, an enlarged resection of the tumor by cervical incision should be performed. Postscript (Ma Lingguo in 2010, 4, 20): The patient had sought medical advice from major hospitals in China, and finally underwent CO2 laser resection + tracheal stenting of the subglottic tracheal mass by external neck approach at the end of June 2008 in our hospital (Department of Otolaryngology, Head and Neck Surgery, Shenzhen People’s Hospital), and had undergone tracheotomy before the operation due to breathing difficulty. The trachea was extremely narrow. The postoperative pathology report was the same as the preoperative one, both of which were amyloidosis. Three months after surgery, the tracheal stent was removed, the cervical tracheotomy was closed, and fiberoptic laryngoscopy and bronchoscopy were performed regularly to observe the patency of the trachea. It has now been nearly two years since the surgery, and no re-stenosis has been seen on regular fiberoptic laryngobronchoscopy. The patient is breathing smoothly, and his voice is clear and loud, and he is working normally. The preoperative and postoperative conditions are shown in the following figure: Preoperative condition Postoperative condition