Laryngeal View Research Articles

Why Can't Physicians Examine the Larynx?

SOME years ago, attention was focused on the almost total failure of the primary physician to detect promptly tumors of the larynx. 1 This glaring defect was attributed to an inability to cope with the technical demands of the angled laryngeal mirror that, for more than 100 years, had been the only available tool for looking over the top of the tongue down to the glottic bed. As a solution, the article recommended replacing the mirror with the relatively new laryngeal telescopes and then proceeded to elaborate their virtues for the primary physician. They were so simple that they required little training; they afforded a clear view of the larynx in a high percentage of cases; and the examination required only a minute. Now the time has come to look back and see who's gaining on whom. With an effective instrument available, are these tumors being discovered earlier? Has there

Observation and Recording of Laryngeal View by Use of a Modified Oblique-angled Type Telescope

A new system for observation and recording of the laryngeal view has been attained by use of a mcdified oblique-angled type telescope conbined with a powerful light source. The scope can be connected to an ordinary 35mm camera with a motor-drive device, a 16mm cine-camera, or a video-TV camera.The laryngeal view through the new scope is quite similar with that obtained by an indirect laryngoscopy. The oblique view angle is 70° for better visualization of the area near the anterior commissure of the vocal folds. We could obtain a clear picture of the laryngeal patholgy even in a 5 y-o child without any difficulty. For still photos a slide-type film (ASA 100) was used with no pushing and successful pictures were obtained in full-size.It was considerd that our tystem is usefull not only for clinical but also for educational purposes.

Microscopic laryngology: teaching techniques.

AbstractMicroscopic laryngoscopy can augment the skills of the laryngologist by adding increased magnification, depth perception and bimanual micromanipulation during direct laryngoscopy.By interfacing the Zeiss operating microscope to a low‐light‐sensitive high‐resolution color television camera, via a fiberoptic bundle, the surgeon may operate and teach, unencumbered by the addition of television equipment. This unique capability enhances the teaching of laryngology by: Crystallizing the three‐dimensional anatomical visual image of the student. Allowing appreciation of the dynamic laryngeal view during direct laryngoscopy. Demonstrating the fine, accurate maneuvers of laryngeal instruments. Allowing the instructor to monitor visually the surgical actions of the novice, advising and directing his manipulations, while allowing the student to gain personal surgical skills and confidence. Demonstrating laryngeal lesions and surgery to an unlimited audience. Recording on color videotape, laryngeal anatomy, lesions and surgery.

Comparison of McGrath(®) Series 5 video laryngoscope with Macintosh laryngoscope: A prospective, randomised trial in patients with normal airways.

Objective:The McGrath Video laryngoscope is a newly developed video laryngoscope that significantly improves laryngeal view and facilitates endotracheal intubation in difficult airways. However in patients with normal airway that is not mentioned before. The aim of this study was to compare the McGrath video laryngoscope with the Macintosh laryngoscope in patients with normal airways.Methods:A total of 100 patients requiring orotracheal intubation, were randomized to either having intubation with the McGrath video laryngoscope or the Macintosh laryngoscope. The primary outcome was the laryngoscopy view using percentage of glottic opening (POGO) score. Secondary outcomes included Cormack and Lehane grading system, time to intubation, number of failed intubations, number of attempts before successful intubation and hemodynamic parameters during intubation.Results:POGO scores were significantly higher in the McGrath group compared with the Macintosh group (p<0.001) despite time to successful intubation was similar in both groups. The McGrath video laryngoscope provided more Grade-I laryngoscopic views than the Macintosh laryngoscope (p<0.001). Number of more than one attempts in order to achieve success was significantly higher in the Macintosh group (p=0.001). The number of minor complications were significantly higher in the Macintosh group (p=0.004). There were no significant changes in hemodynamic responses between the two groups (p>0.05).Conclusion:McGrath video laryngoscope allows patients with normal airways to achieve higher POGO scores and significantly more Grade-I laryngoscopic views when compared with the Macintosh laryngoscope.

SELECTED PROBLEMS IN THE DIAGNOSIS OF LARYNGEAL CARCINOMA

THIS report is the direct outgrowth of efforts to photograph various types of laryngeal pathology for teaching purposes. In the course of accumulating and reviewing pictures we were impressed by the problem of leucoplakia in its varied forms and associated incidence of carcinoma of the vocal cord. The relative lack of symptoms in the extracordal or extrinsic cancer and the amazing extent to which such lesions had often progressed before recognition were consistently disturbing observations. We became interested in correlating mirror and direct laryngeal views with operative specimens of the same patient. The striking similarity between the gross appearance of some forms of tuberculosis of the larynx and carcinomas of the larynx was evident on numerous occasions. Inasmuch as the choice of therapy often involved problems in diagnosis, some consideration of treatment has been included. For a more definitive analysis of these particular topics than was afforded by photography, we

A view of the larynx through a new stroboscope

A view of the larynx through a new stroboscope