Figure 26: a – extension of the transcervical myotomy of the cricopharyngeal muscle (about 4 cm) with protection of the inferior laryngeal nerve with laryngo-hyoidopexy. The myotomy should be extended in a cranial and caudal direction, all muscle fibers have to be transsected in the area of the myotomy; b – additionally to myotomy, a suspension suture is placed through the mandible in order to draw the laryngohyoid complex under the base of the tongue for protection; c – 43-year-old patient after surgery of an ependymoma of the 4th ventricle. After myotomy, laryngo-hyoido-mentopexy was performed. The small blue arrows show osteosynthesis plates of the hyoido-mentopexy. The blue arrow shows the laryngeal vestibule protected by the base of the tongue. The red arrow heads show soft part opacification of the base of tongue. H = hyoid.