Development of three‐dimensional laryngostroboscopy for office‐based laryngeal diagnostics and phonosurgical therapy

Abstract

Objective To develop a three‐dimensional (3D) laryngostroboscopic examination unit, compare the optic playback quality in relation to established 2D procedures, and report the first case series using 3D rigid laryngostroboscopy for diagnosis and management of laryngotracheal diseases. Study Design Laboratory study, prospective case series. Methods The optical efficacy of newly developed rigid 3D endoscopes was examined in a laboratory setting. Diagnostic suitability was investigated in 100 subjects (50 male, 50 female) receiving 2D high‐definition (HD) and 3D laryngostroboscopy. Two of the subjects subsequently underwent 3D‐assisted office‐based transoral phonosurgery under local anesthesia. Main outcome measures were comparative visualization of laryngotracheal pathologies, influence on preoperative planning, and evaluation of prognostic factors for the outcome of phonosurgical interventions. Results Three‐dimensional endostroboscopic procedures were effectively optimized to establish an examination protocol for all‐day clinical use. Office‐based 3D laryngostroboscopy was successfully applied in subjects with normal anatomy (n = 10) and various laryngotracheal findings (n = 90). In comparison to 2D HD videolaryngostroboscopy, the 3D view offered enhanced visualization of laryngotracheal anatomy, with qualitatively improved depth perception and spatial representation. In organic pathologies, this resulted in a more precise indication of phonosurgical procedures, increased accuracy in surgical planning, facilitated office‐based endoscopic surgery, and better evaluation of prognostic factors for the outcome of phonosurgical interventions. Conclusion Three‐dimensional laryngostroboscopy proved to increase the understanding of functional and surgical anatomy. Its application has enormous potential for improving the diagnostic value of laryngoscopy, surgical precision in laryngotracheal interventions, tissue preservation, and methods of teaching. Level of Evidence NA Laryngoscope, 128:2823–2831, 2018

Harnessing Machine Learning in Vocal Arts Medicine: A Random Forest Application for “Fach” Classification in Opera

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A systematic review on efficacy, safety and cost-effectiveness of office-based laryngeal biopsy

“…This includes laryngeal and hypopharyngeal biopsy, vocal fold injections, and laser surgery for vocal fold polyps and granulomas. [6][7][8] Laryngeal procedures carried out under local anaesthesia have advantages and disadvantages. The advantages include earlier diagnosis and access to treatment, that they can be performed on patients not suitable for general anaesthesia, and that they are suitable for patients with difficult anatomy and significant co-morbidities.…”

Three dimensional printed models of the airway for preoperative planning of open Laryngotracheal surgery in children: Surgeon's perception of utility

“…These models enable preoperative in vitro planning [2,3], production of tailor-made grafts and stents [4,5], advanced training of surgical residents and improved patient education [6]. In otolaryngology, recent studies reported the use of 3D models of the larynx and trachea for laryngotracheal reconstruction (LTR) rehearsal [7], for training in endoscopic balloon dilations of subglottic stenosis [8], for creating tissue-engineered airway grafts [9,10], and for other procedures [11][12][13][14][15]. To the best of our knowledge, assessment of a possible advantage of utilizing these models for preoperative planning of open laryngotracheal surgery based on a validated scoring system has not been reported.…”