title: A novel distending laryngoscope: implications in transoral surgery.
abstract: The objective is to describe an innovative laryngoscope developed to improve visualization, provide greater exposure, and enhance precision and success during transoral procedures. A retrospective review of 170 patients who underwent transoral surgery with a new distending laryngoscope was conducted. We compared and contrasted our exposure within the oropharynx, hypopharynx, and larynx using the laryngoscope with that of currently available instrumentation. Specific mechanical dimensions of the laryngoscope along with the provided working field were calculated. Experience with the new laryngoscope afforded improved exposure over currently available instrumentation. This laryngoscope was manufactured using design elements from the Steiner, Weerda, and Lindholm laryngoscopes, including an anteriorly curved distal tip, distending capability, and lateral wings to protect against tongue herniation. The panoramic view was increased allowing for wider exposure of the supraglottis and pharynx. This design provided enhanced transoral visibility and working room for improved bimanual instrumentation. Direct laryngoscopic technique and instrumentation have continued to evolve. Over the last two decades, there has been a significant movement towards minimally invasive transoral surgical techniques fueling innovative concepts and advancement in laryngoscopic design and application. We present our experience with an innovative laryngoscope allowing for improved visualization, greater exposure, and enhanced proficiency with transoral technique.
authors: Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA.
authors: Michael L
authors: ML
authors: Hinni
authors: Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA. alpen@email.arizona.edu.
authors: Alpen B
authors: AB
authors: Patel
authors: Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA.
authors: Thomas H
authors: TH
authors: Nagel
authors: Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA.
authors: Brittany E
authors: BE
authors: Howard
mesh_terms: D004867:Equipment Design; D006801:Humans; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000295:instrumentation*; D009055:Mouth; D057605:Natural Orifice Endoscopic Surgery / Q000295:instrumentation; D012189:Retrospective Studies
keywords: Laryngoscope; Laryngoscopy; Transoral; Transoral laser microsurgery; Transoral robotic surgery
references: Laryngoscope. 1972 Dec;82(12):2204-16
references: 4675172
references: Ann Otol Rhinol Laryngol. 2003 Sep;112(9 Pt 1):787-97
references: 14535563
references: Laryngoscope. 1978 Sep;88(9 Pt 1):1399-420
references: 682798
references: Am J Otolaryngol. 1995 Jan-Feb;16(1):2-11
references: 7717468
references: Laryngoscope. 2009 Mar;119(3):508-15
references: 19235742
references: Ann Otol Rhinol Laryngol. 1972 Dec;81(6):791-8
references: 4636137
references: Head Neck. 2011 Dec;33(12):1683-94
references: 21284056
references: Laryngoscope. 2006 Dec;116(12):2150-5
references: 17146388
references: Laryngoscope. 2011 Nov;121(11):2381-90
references: 21882203
references: J Voice. 1998 Mar;12(1):1-6
references: 9619973
references: Laryngoscope. 1983 May;93(5):639-41
references: 6843257