Abstract
Management of Difficult Laryngeal Exposure with Two Surgeons by Using the Flexible Fiberscope
Highlights
Endolaryngeal microsurgery using a direct laryngoscope was a well-established procedure in phonosurgery [1]
The flexible fiberscope with a video system could remarkably improve visualization of the larynx. This approach provided an alternative way for managing difficult laryngeal exposure during suspension microlaryngoscopy in phonomicrosurgery by two surgeons, without requirement of any specially designed instruments
3 patients presented with difficult laryngeal exposure that were operated under suspension microlaryngoscopy using readily available flexible fiberscope along with a video system and microlaryngoscopic instruments, without requirement of any specially designed instruments
Summary
Endolaryngeal microsurgery using a direct laryngoscope was a well-established procedure in phonosurgery [1]. Difficult laryngeal exposure during suspension microlaryngoscopic surgeries was not an uncommon situation encountered by the phonosurgeons [2]. Low exposure of the larynx could make laryngeal microsurgery difficult or even impossible [3]. Difficult laryngeal exposure might lead to unnecessary trauma, incomplete surgery and even abortion of the procedure [2]. There were numerous literatures discussing about prediction of difficult laryngeal exposure during suspension microlaryngoscopic surgeries. Thyroid-mandible angle might be a sensitive, reliable, and useful predictor of difficult laryngeal exposure in both men and women [4]. A muscular neck, or retrognathia were likely to present difficult laryngeal exposure, and preoperative measurement of these predictors might be useful in preparing for microlaryngosurgery [5]. The Laryngoscore might be a good predictor of difficult laryngeal exposure and assist in selecting the ideal candidates for operative microlaryngoscopy [6,7]
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