A Novel Distending Laryngoscope: Implications in Transoral Surgery

Abstract

Objectives:

1) Describe an innovative laryngoscope developed to improve visualization, provide greater exposure, and enhance precision during transoral procedures. 2) Demonstrate improved proficiency and success with transoral surgery within the oropharynx, hypopharynx, and larynx. 3) Analyze and compare specific mechanical dimensions and exposure with that of currently available instrumentation. 4) Identify the advantages of use with minimally invasive surgical techniques and approaches, including transoral laser microsurgery and transoral robotic surgery.

Methods:

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 new laryngoscope with that of currently available instrumentation. Specific mechanical dimensions of the laryngoscope along with the provided working field were calculated.

Results:

Experience with the new distending laryngoscope afforded better exposure than currently available instrumentation. This new prototype 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 of view was increased when engaged. This design provided enhanced transoral visibility and working room, allowing for improved bimanual instrumentation.

Conclusions:

Direct laryngoscopic technique and instrumentation has 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 precision with transoral technique.