Inzidenz spatelbedingter Nebenwirkungen der Mikrolaryngoskopie

Müller, A.; Verges, L.; Schleier, Peter; Wohlfarth, M.; Gottschall, Reiner

doi:10.1007/s00106-002-0640-x

Cited by 10 publications

(2 citation statements)

References 13 publications

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“…Klussmann et al l 5 found an incidence of nerve complications of 13 of 339 patients (3.8%), of which 9 cases (2.7%) involved the lingual nerve and 4 (1.3%) involved the hypoglossal nerve. In an equally thorough study, Muller et al 16 reported no nerve lesions at all in 81 patients.…”

Section: Discussionmentioning

confidence: 93%

Tongue Paresthesia and Dysgeusia following Operative Microlaryngoscopy

Tessema¹,

Sulica²,

Yu³

et al. 2006

Ann Otol Rhinol Laryngol

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Section: Discussionmentioning

confidence: 93%

Tongue Paresthesia and Dysgeusia following Operative Microlaryngoscopy

Tessema¹,

Sulica²,

Yu³

et al. 2006

Ann Otol Rhinol Laryngol

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“…Therefore, a considerable number of patients are not suitable for TLM ( 38 ). Furthermore, in TLM, forces which are applied to the maxillary incisors and laryngopharynx by the rigid microlaryngoscope may cause postoperative complications including transient laryngeal edema, hematoma, hypoglossal palsy, taste alteration, dysphagia or dental injuries ( 19 , 39 ).…”

Section: Discussionmentioning

confidence: 99%

A novel 3D-printed laryngoscope with integrated working channels for laryngeal surgery

Kienle¹,

Schild²,

Böhm³

et al. 2023

Front. Surg.

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BackgroundFor the surgical treatment of early-stage laryngeal cancer, the use of transoral laser microsurgery (TLM) has emerged as the gold standard. However, this procedure requires a straight line of sight to the operating field. Therefore, the patient's neck needs to be brought into a hyperextended position. In a considerable number of patients, this is not possible due to anomalies in the cervical spine anatomy or soft tissue scarring, e.g., after radiation. In these cases, adequate visualization of relevant laryngeal structures cannot be ensured using a conventional rigid operating laryngoscope, which may negatively affect the outcome of these patients.MethodsWe present a system based on a 3D-printed prototype of a curved laryngoscope with three integrated working channels (sMAC). The curved profile of the sMAC-laryngoscope is specifically adapted to the nonlinear anatomy of the upper airway structures. The central working channel provides access for flexible video endoscope imaging of the operating field while the two remaining channels provide access for flexible instrumentation. In a user study (n = 11), visualization and reachability of relevant laryngeal landmarks as well as the feasibility of basic surgical procedures with the proposed system were examined in a patient simulator. In a second setup, the system was evaluated for its applicability in a human body donor.ResultsAll participants of the user study were able to visualize, reach and manipulate the relevant laryngeal landmarks. Reaching those took significantly less time in the second attempt compared to the first one (27.5 s ± 5.2 s vs. 39.7 s ± 16.5 s, p = 0.008) indicating a significant learning curve for handling the system. Instrument changes were performed quickly and reliably by all participants (10.9 s ± 1.7 s). All participants were able to bring the bimanual instruments into position for a vocal fold incision. Relevant laryngeal landmarks could be visualized and reached in the human body donor setup.ConclusionPossibly, the proposed system may develop into an alternative treatment option for patients with early-stage laryngeal cancer and restricted mobility of the cervical spine in the future. Further improvements of the system could include finer end effectors and a flexible instrument with a laser cutting tool.

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