Direct and Indirect Laryngoscopy: Equipment and TechniquesDiscussion

Collins, Stephen R.

doi:10.4187/respcare.03033

Cited by 56 publications

(56 citation statements)

References 100 publications

(69 reference statements)

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“…As a result, many are reluctant to forego the 3D representation in office‐based endoscopic applications . The direct laryngoscopy, which permits stereoscopic examination by the surgical microscope, cannot be used in voice diagnostics because it requires dorsiflexion of the head and general anesthesia with intubation narcosis or jet ventilation . Thus, this diagnostic procedure is more effortful, complex, uncomfortable, invasive, and riskier for the patient.…”

Section: Introductionmentioning

confidence: 99%

“…17,18 The direct laryngoscopy, which permits stereoscopic examination by the surgical microscope, cannot be used in voice diagnostics because it requires dorsiflexion of the head and general anesthesia with intubation narcosis or jet ventilation. [19][20][21] Thus, this diagnostic procedure is more effortful, complex, uncomfortable, invasive, and riskier for the patient. In addition, the anesthesia makes it impossible to observe the gross respiratory vocal fold movements from the phonation to the respiratory position and vice versa, as well as the fine phonatory vibrations of the vocal folds during vocalization.…”

Section: Introductionmentioning

confidence: 99%

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Development of three‐dimensional laryngostroboscopy for office‐based laryngeal diagnostics and phonosurgical therapy

et al. 2018

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Objective To develop a three‐dimensional (3D) laryngostroboscopic examination unit, compare the optic playback quality in relation to established 2D procedures, and report the first case series using 3D rigid laryngostroboscopy for diagnosis and management of laryngotracheal diseases. Study Design Laboratory study, prospective case series. Methods The optical efficacy of newly developed rigid 3D endoscopes was examined in a laboratory setting. Diagnostic suitability was investigated in 100 subjects (50 male, 50 female) receiving 2D high‐definition (HD) and 3D laryngostroboscopy. Two of the subjects subsequently underwent 3D‐assisted office‐based transoral phonosurgery under local anesthesia. Main outcome measures were comparative visualization of laryngotracheal pathologies, influence on preoperative planning, and evaluation of prognostic factors for the outcome of phonosurgical interventions. Results Three‐dimensional endostroboscopic procedures were effectively optimized to establish an examination protocol for all‐day clinical use. Office‐based 3D laryngostroboscopy was successfully applied in subjects with normal anatomy (n = 10) and various laryngotracheal findings (n = 90). In comparison to 2D HD videolaryngostroboscopy, the 3D view offered enhanced visualization of laryngotracheal anatomy, with qualitatively improved depth perception and spatial representation. In organic pathologies, this resulted in a more precise indication of phonosurgical procedures, increased accuracy in surgical planning, facilitated office‐based endoscopic surgery, and better evaluation of prognostic factors for the outcome of phonosurgical interventions. Conclusion Three‐dimensional laryngostroboscopy proved to increase the understanding of functional and surgical anatomy. Its application has enormous potential for improving the diagnostic value of laryngoscopy, surgical precision in laryngotracheal interventions, tissue preservation, and methods of teaching. Level of Evidence NA Laryngoscope, 128:2823–2831, 2018

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of three‐dimensional laryngostroboscopy for office‐based laryngeal diagnostics and phonosurgical therapy

et al. 2018

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“…Rigid laryngoscopes are endoscopes equipped with a source of light that have the ability to provide direct views of the larynx, epiglottis, and vocal cords . The laryngoscope is composed of a handle and a lighted blade that is generally powered by batteries or a battery pack contained in the handle.…”

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confidence: 99%

“…The laryngoscope is composed of a handle and a lighted blade that is generally powered by batteries or a battery pack contained in the handle. The health care provider inserts the blade (straight or curved) into the patient's mouth to examine the patient's larynx, epiglottis, and vocal cords, and insert an endotracheal tube . The Macintosh blade is the most commonly used curved blade and the Miller blade is the most commonly used straight blade (Figure ) …”

mentioning

confidence: 99%

“…R igid laryngoscopes are endoscopes equipped with a source of light that have the ability to provide direct views of the larynx, epiglottis, and vocal cords. 1 The laryngoscope is composed of a handle and a lighted blade that is generally powered by batteries or a battery pack contained in the handle. The health care provider inserts the blade (straight or curved) into the patient's mouth to examine the patient's larynx, epiglottis, and vocal cords, and insert an endotracheal tube.…”

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confidence: 99%

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Contamination and Disinfection of Rigid Laryngoscopes: A Literature Review

Wicklin¹

2019

AORN Journal

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This article reviews current literature about the contamination of laryngoscope blades and handles, disinfection practices for laryngoscope blades and handles, and environmental effects and costs of reusable and single‐use laryngoscopes. This review shows that inadequately processed rigid laryngoscopes may have the ability to transmit infections to patients and health care personnel. Although the laryngoscope handle has been considered a noncritical item that contacts only intact skin, health care team members should consider both the laryngoscope blade and handle as semicritical items and process them by high‐level disinfection (HLD) or steam sterilization according to manufacturer's instructions. The fewest environmental effects occur when a reusable stainless‐steel laryngoscope is processed by HLD. Laryngoscope costs are lower for processing reusable laryngoscope handles and blades by HLD and highest for single‐use laryngoscopes. Evidence‐based guidelines are needed to specify and standardize best practices for processing rigid laryngoscopes.

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