The Benefits and Limitations of Targeted Training in Flexible Transnasal Laryngoscopy Diagnosis

Russell, Kimberly A.; Brook, Christopher; Platt, Michael P.; Grillone, Gregory A.; Aliphas, Avner; Noordzij, J. Pieter

doi:10.1001/jamaoto.2017.0120

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…Therefore, this result may not apply in other countries or regions with low frequencies. However, it is worth noting that there is a direct correlation between the proficiency of an intubation device and its effect in use [28]. In a national survey conducted in the United Kingdom, 91% of anesthesiology departments and 50% of intensive care units were equipped with video laryngoscopes in public hospitals; nevertheless, they were not prevalent in emergency or pediatric departments, or private hospitals [29].…”

Section: Discussionmentioning

confidence: 99%

Intubation of non-difficult airways using video laryngoscope versus direct laryngoscope: a randomized, parallel-group study

Liu

Zhu

et al. 2019

BMC Anesthesiol

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Background The video laryngoscope is recommended for intubating difficult airways. The present study aimed to determine whether the video laryngoscope can further improve intubation success rates compared with the direct laryngoscope in patients with non-difficult airways. Methods In total, 360 patients scheduled for elective abdominal surgeries were randomly assigned to undergo intubation using either a video laryngoscope ( n = 179) or a direct laryngoscope ( n = 181). The following parameters were measured: mouth opening; thyromental distance; sternomental distance; shape angle of the tracheal catheter; and glottic exposure grade. Results The percentage of patients with level I-II of total glottic exposure in the video laryngoscope group was 100% versus 63.5% in the direct laryngoscope group ( P < 0.001). The one-attempt success rate of intubation was 96.1% using a video laryngoscope versus 90.1% using a direct laryngoscope ( P = 0.024). The intubation success rate using a video laryngoscope was 100% versus 94.5% using a direct laryngoscope ( P = 0.004). Immediate oropharyngeal injury occurred in 5.1% of patients intubated using a direct laryngoscope versus 1.1% using a video laryngoscope ( P = 0.033). On postoperative day 1, obvious hoarseness was exhibited by 7.9% of patients intubated using a direct laryngoscope versus 2.8% using a video laryngoscope ( P = 0.035). The grade of glottic exposure and catheter shape angle were independent risk factors for tracheal intubation failure. Thyromental distance, shape angle, glottic exposure time, and surgical position were independent risk factors for postoperative complications. Thyromental distance and glottic exposure time were independent risk factors for complications lasting > 2 days. Conclusions Intubation using a video laryngoscope yielded significantly higher intubation success rates and significantly fewer postoperative complications than direct laryngoscopy in patients with non-difficult airways. Trial registration Chinese Clinical Trial Registry. No: ChiCTR-IOR-16009023 . Prospective registration.

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Section: Discussionmentioning

confidence: 99%

Intubation of non-difficult airways using video laryngoscope versus direct laryngoscope: a randomized, parallel-group study

Liu

Zhu

et al. 2019

BMC Anesthesiol

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“…18 For example, Russell et al showed that trainees had a better understanding of FNE after watching a narrated educational video of the procedure. 19 Considering that video-based learning can be accessed from any location, it could provide a more economical and effective method for delivering an induction programme.…”

Section: Discussionmentioning

confidence: 99%

Assessment of YouTube as an educational tool in teaching flexible nasendoscopy and peritonsillar abscess drainage

et al. 2022

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Background Partly as a result of coronavirus disease 2019, YouTube has become a more frequent educational source for otolaryngology trainees. This study sought to assess the quality of flexible nasendoscopy and peritonsillar abscess drainage videos. Method YouTube was systematically searched using 13 terms related to flexible nasendoscopy and peritonsillar abscess drainage. Two independent reviewers assessed the quality of each video using the Laparoscopic Video Educational Guidelines. Results Twenty-seven videos were deemed suitable. The mean total Laparoscopic Video Educational Guidelines scores for videos on flexible nasendoscopy (18 videos) and peritonsillar abscess drainage (9 videos) were 10.3 (standard deviation = 3.1) and 11.7 (standard deviation = 4.6), respectively. Most of the videos were deemed of medium quality. The Laparoscopic Video Educational Guidelines score correlated positively with flexible nasendoscopy video length and how recently a peritonsillar abscess drainage video had been uploaded. Conclusion The limited high-quality videos on YouTube are difficult to identify from the search metrics available. Trainees and ENT induction programmes would benefit greatly from an online platform that contains a catalogue of high-quality surgical videos.

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“…Office-based flexible transnasal laryngoscopy is a common routine procedure since many years. The development of new technical equipment such as flexible high-definition endoscopes allows for very precise examination [1][2][3][4][5][6][7][8][9]. The basic principle for getting optimal magnification in laryngoscopy is to decrease the distance of the lens to the target, i.e., the nearer one gets to the vocal fold, the more details one can see.…”

Section: Discussionmentioning

confidence: 99%

Dipping and rotating: two maneuvers to achieve maximum magnification during indirect transnasal laryngoscopy

Fleischer

Pflug

Heß³

2020

Eur Arch Otorhinolaryngol

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Background Since many years, office-based flexible transnasal laryngoscopy is a common routine procedure. The development of new technical equipment such as high-definition cameras and flexible tip-chip endoscopes nowadays allows for much more precise examination than a few years ago. In contrast to rigid laryngoscopy, it is possible to move the tip of the endoscope close to the vocal folds and to other structures of interest. Nevertheless, without professional handling of the equipment, one cannot benefit from the potential of the newest technology. Method Two easily performed and very helpful maneuvers in flexible endoscopy are described. The “dipping maneuver” enables a maximum magnification of the mucosal surfaces of the endolarynx as well as the examination of the subglottal region and the trachea by positioning the tip of the endoscope very close to the vocal folds or even in the upper trachea during long transnasal inspiration. During the “rotation laryngoscopy”, the tip of the endoscope is positioned in the posterior interarytenoid region by rotating the flexible endoscope by 180° and advancing it close to the glottis. This allows a close-up examination of the anterior commissure, the inferior aspect of the vocal folds and the inside of the Morgagni’s ventricle. Before performing transnasal flexible endoscopy, we routinely apply topical anesthesia sprayed intranasally. Conclusion The described techniques of flexible endoscopy are easily performed and allow a maximum magnification of the mucosal surfaces and otherwise not visible regions of the endolarynx.

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The Benefits and Limitations of Targeted Training in Flexible Transnasal Laryngoscopy Diagnosis

Abstract: Learning of flexible laryngoscopy can be improved with the use of a teaching video; however, additional interventions are needed to attain competence in accurately diagnosing upper airway lesions. Clinicians who seek to perform flexible laryngoscopy require robust training.

Cited by 9 publications

References 18 publications

Intubation of non-difficult airways using video laryngoscope versus direct laryngoscope: a randomized, parallel-group study

Intubation of non-difficult airways using video laryngoscope versus direct laryngoscope: a randomized, parallel-group study

Assessment of YouTube as an educational tool in teaching flexible nasendoscopy and peritonsillar abscess drainage

Dipping and rotating: two maneuvers to achieve maximum magnification during indirect transnasal laryngoscopy

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