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. 2019 Jan;23(1):18-24.
doi: 10.1055/s-0038-1660825. Epub 2018 Aug 9.

Variant of the Technique for Laryngeal Microsurgery in Cases of Difficult Laryngoscopy

Antonio Roberto Ferreira Setton  1 , Jeferson Sampaio D'avila  1 , Ricardo Queiróz Gurgel  2 , Domingos Hiroshi Tsuji  3 , Daniel Vasconcelos D'avila  3 , Carlos Rodolfo Tavares de Góis  1 , Ana Taise de Oliveira Meurer  4 , Helaina Peixoto Gurgel  4
Affiliations

Variant of the Technique for Laryngeal Microsurgery in Cases of Difficult Laryngoscopy

Antonio Roberto Ferreira Setton et al. Int Arch Otorhinolaryngol. 2019 Jan.

Abstract

Introduction Low exposure of the larynx can make laryngeal microsurgery difficult or even impossible. The application of rigid and contact endoscopy enabled oblique and retrograde angled visualization, allowing transoperative staging with greater reach of the anatomical areas. However, there is difficulty or even impossibility of performing the surgical act, due to the incompatibility of the angled path with the straight surgical tools. Objective To demonstrate the efficiency of the variant of the technique for laryngeal microsurgery in cases of difficult laryngoscopy and to analyze the new surgical instruments specific to the endoscopic procedure. Methods This is a cross-sectional retrospective study, based on the analysis of 30 medical records of patients treated surgically at a philanthropic hospital in the state of Sergipe, Brazil, between the years of 2014 and 2015. Results The technical variant used 30- and 70-degree endoscopes that provided complete oblique view of the endolarynx. The association of angled instruments (forceps, suction pumps, retractors and scissors) enabled the execution of the surgical procedures. Conclusion The association of rigid endoscopy with angled instruments promoted full visualization of the surgical lesion and operative resolution.

Keywords: endoscopy; larynx; surgery; technical variant.

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Figures

Fig. 1
Fig. 1
D'Avila's areas.
Fig. 2
Fig. 2
Material for collection of anthropometric measurements.
Fig. 3
Fig. 3
Measurement of cervical circumference.
Fig. 4
Fig. 4
Measurement of oral opening.
Fig. 5
Fig. 5
Measurement of thyromental distance.
Fig. 6
Fig. 6
Material developed for the technical variant.
See this image and copyright information in PMC

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