Management of Difficult Laryngeal Exposure During Suspension Microlaryngoscopy

Difficult laryngeal exposure during suspension microlaryngoscopic surgeries is a common situation encountered by the phonosurgeons nowadays. It leads to unnecessary trauma, incomplete surgery and even abortion of the procedure. Although various methods have been described to counter the situation, t...

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Bibliographic Details
Published in:Indian journal of otolaryngology, and head, and neck surgery and head, and neck surgery, 2019-03, Vol.71 (1), p.81-85
Main Authors: Joshi, Anagha Atul, Velecharla, Madhu Sudhan, Patel, Tejal Sunil, Shah, Kshitij Dhaval, Bradoo, Renuka Anil
Format: Article
Language:English
Subjects:
Endoscopy
Head and Neck Surgery
Medicine
Medicine & Public Health
Original
Original Article
Otorhinolaryngology
Speech disorders
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Summary:Difficult laryngeal exposure during suspension microlaryngoscopic surgeries is a common situation encountered by the phonosurgeons nowadays. It leads to unnecessary trauma, incomplete surgery and even abortion of the procedure. Although various methods have been described to counter the situation, they might not be adequate in some cases with very anteriorly placed larynx. This study is intended to determine the utility of angled rigid endoscope along with malleable endoscopic instruments to improve surgical access in cases with inadequate glottic exposure during suspension microlaryngoscopy. In this cross sectional study conducted at Lokmanya Tilak Municipal Medical College and General Hospital in Mumbai, 50 patients of voice disorders who underwent Suspension Microlaryngoscopy from July 2014 to December 2017 were included. Out of these patients, 5 patients (10%) presented with difficult laryngeal exposure that were operated using readily available angled rigid endoscope along with malleable endoscopic instruments, without requirement of any specially designed instruments. There was improvement in laryngeal exposure in all the cases following utilisation of angled endoscopes. The surgeries were carried out under video monitor guidance with complete excision of the vocal cord lesions. Our study concluded that the cases in which the laryngeal exposure cannot be improved even by various external procedures, can be enhanced by application of angled rigid endoscopes and the vocal cord lesions can be excised completely by using malleable endoscopic instruments.
ISSN:2231-3796
0973-7707
DOI:10.1007/s12070-018-1481-6