Kim BH, et al. - In the present study, the researchers sought to detect preoperative predictors of unstable exposure of vocal folds with a focus on the anterior commissure (AC) prior to laryngeal microscopic surgery. For this prospective study, participants were classified into four groups based on the degree of AC exposure during laryngeal microscopic surgery. For the analysis, these groups were subdivided into unstable exposure and stable exposure subgroups depending on whether external manipulation was needed to achieve AC exposure. Participants in the study were 59 patients. According to findings, unstable AC exposure was accurately predicted by the thyroid-mental distance (TMD) ratio < 1.25. The chance of getting stable exposure of the anterior commissure is low if there is no increase in the distance between the thyroid notch and the mental prominence (TMD) more than 25% on neck extension.