Suspension Microlaryngoscopy in the Boyce Position with a New Suspension Gallows

Grundfast, Kenneth M.; Strong, M. Stuart; Vaughn, Charles W.; Vos, Paul De

doi:10.1177/000348947808700419

Cited by 22 publications

(18 citation statements)

References 11 publications

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“…All patients underwent rigid direct laryngoscopy under either general anesthesia or monitored anesthesia care. The latter consisted of a combination of topical anesthesia to the pharynx and larynx (4% lidocaine) and intravenous sedation and were all for endoscopic vocal fold injection, as previously described 12,13 . Rigid laryngoscopy was performed with a variety of different laryngoscopes, and suspension of the laryngoscopes was performed either manually for endoscopic vocal fold injection or using the Boston University suspension device (Pilling Corp., Fort Washington, PA) 14 .…”

Section: Methodsmentioning

confidence: 99%

Oropharyngeal Complications Of Suspension Laryngoscopy: A Prospective Study

et al. 2005

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Section: Methodsmentioning

confidence: 99%

Oropharyngeal Complications Of Suspension Laryngoscopy: A Prospective Study

et al. 2005

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“…Subsequently, the suspension force measurements were obtained with a strain gauge attached to a handle extension (without support of the head). During the initial trial, the assis- 10 is necessary to measure the vector force at the distal lumen of the laryngoscope, just above the vocal folds. Once the optimal exposure was obtained, the force measurements were recorded.…”

Section: Methodsmentioning

confidence: 99%

“…Many surgeons preferred to support the laryngoscope holder from a platform rather than the chest wall to avoid compression of the thoracic cavity. It was not until the 1970s 10 · 24 that principles of exposure espoused by Jackson and Killian 4 were combined in modern suspension gallows, 10 which could create elevated-vector suspension (Fig 7 5 ). Grundfast and the Boston University group introduced this device, for which the mechanical works were a window crank.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Forces and Position Required for Direct Laryngoscopic Exposure of the Anterior Vocal Folds

Hochman¹,

Zeitels²,

Heaton³

1999

Ann Otol Rhinol Laryngol

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The sniffing position is traditionally considered optimal for direct laryngoscopic examination of the vocal folds. This study examined head and neck positions associated with ideal exposure of the anterior glottal commissure with a variety of laryngoscopes. A prospective investigation was done in 20 patients by comparing the force required to expose the anterior vocal folds by utilizing 3 head and neck positions with 3 different-sized tubular laryngoscopes. The completeness of anterior glottal exposure was rated and the force required to achieve this exposure was measured with a strain gauge. Three positions relating the atlanto-occipital and cervicothoracic vertebrae were analyzed: 1) extension-extension. 2) sniffing: extension-flexion, and 3) flexion-flexion. Head and neck position and laryngoscope size were both statistically significant factors for achieving complete anterior vocal fold exposure. Regardless of the laryngoscope, the number of patients in whom complete exposure could be achieved increased gradually when the position was changed from extension-extension to extension-flexion to flexion-flexion. Complete exposure was inversely related to larger laryngoscope size. According to the data herein, the flexion-flexion position provides the best glottal exposure for endotracheal intubation in those patients who are anatomically predisposed to difficulty in direct examination of the glottis. Because this places the laryngoscope lumen in a vertical position, this position is inappropriate for microlaryngoscopy. The study reinforced the concept that the sniffing position is the optimal position for microlaryngoscopy because it enables the use of the largest-lumened laryngoscope. This facilitates ideal exposure of the anterior vocal folds, which is necessary for phonomicrosurgery.

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“…Estes movimentos surgem ou são intensificados durante a microlaringoscopia de suspensão, uma vez que o manuseio dos micro-instrumentos causa uma vibração sete vezes maior ao longo do corpo dos mesmos 11 . Dificuldades, complicações ou mesmo impossibilidade de se obter uma visão estável e adequada da glote à microlaringoscopia têm sido descritos na literatura Otorrinolaringológica 12 . Rischtsmeyer e Scher relataram 8% (3/36) de complicações resultantes da laringoscopia direta, dentre estes, 5% (2/36) tiveram fratura dos dentes incisivos superiores e 3% (1/36) apresentaram paralisia transitória de prega vocal 13 .…”

Section: Discussionunclassified

Desenvolvimento de protótipo para aplicação do laser de CO2 na laringe humana a curtas distâncias

Morgado

Wagner

Neves

et al. 2002

Rev. Bras. Otorrinolaringol.

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Introdução: A aplicação do laser de CO 2 na laringe é feito utilizando-se objetivas de f = 350 ou 400mm, as quais convergem os raios para uma área mínima. A dimensão desta área ou cintura do feixe, é determinada por: 2ω0 = λf /πω 2 , onde 2ω é o diâmetro do feixe laser na entrada das lentes, λ o comprimento de onda do laser de CO 2 . Desenvolvemos uma ponteira cirúrgica que converge e libera o feixe de laser próximo à laringe humana. Esta pequena cintura de feixe aumenta a precisão cirúrgica reduzindo o dano tecidual adjacente. Objetivo: Apresentar um sistema de convergência e liberação de raios laser próximo à laringe humana. Forma de estudo: Clínico prospectivo. Material e Método: O dispositivo é constituído por duas hastes metálicas cilíndricas unidas formando um ângulo de 135 o com a horizontal. Um espelho posicionado nesta junção desvia o eixo do feixe luminoso neste mesmo ângulo. A ponteira foi acoplada ao braço articulado do laser e a exposição da glote foi feita por meio da videolaringoscopia angulada. O laser foi ajustado à potência entre 0,5 e 2,0 W com tempo de exposição de 0,05s. Três pacientes portadores de pólipo de prega vocal foram tratados com esta técnica. Resultados: O diâmetro resultante da cintura do feixe foi de 200 a 250 µm (λCO 2 = 10,6 µm). Não houve dificuldades técnicas para a exposição da lesão alvo; as imagens foram adequadas para o tratamento. Não observamos sangramento ou tecido carbonizado adjacente à exérese. Em acompanhamento pós-operatório por dois meses não foram observadas retrações teciduais excessivas. Conclusão: O sistema óptico desenvolvido produziu cinturas de feixe menores que as utilizadas atualmente, provando ser útil no tratamento de pólipos de pregas vocais.

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Suspension Microlaryngoscopy in the Boyce Position with a New Suspension Gallows

Cited by 22 publications

References 11 publications

Oropharyngeal Complications Of Suspension Laryngoscopy: A Prospective Study

Oropharyngeal Complications Of Suspension Laryngoscopy: A Prospective Study

Analysis of the Forces and Position Required for Direct Laryngoscopic Exposure of the Anterior Vocal Folds

Desenvolvimento de protótipo para aplicação do laser de CO2 na laringe humana a curtas distâncias

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