Three-Dimensional Direct Laryngoscopy and Bronchoscopy

Abstract

Importance: This is the first description of 3-dimensional (3D) pediatric airway endoscopy in the otolaryngology literature detailing the superior visualization with this technology. Ultimately, enhanced optics may further improve the treatment of airway pathology.Objective: To report the first case series examining the use of 3D direct laryngoscopy and bronchoscopy (DLB) in the diagnosis and management of laryngotracheal pathology.Design: Case series.Setting: Tertiary care pediatric hospital.Participants: Three patients underwent both telescopic 2-dimensional (2D) and 3D DLB for comparison purposes: a 12-year-old boy for visualization of complete tracheal rings, a 23-year-old man for dilation of tracheal stenosis, and a 4-month-old boy for resection of subglottic cysts.Main Outcome Measures: Enhanced visualization of laryngotracheal pathology and facilitated endoscopic surgery.Results: To our knowledge, this is the first case series in the otolaryngology literature examining the use of 3D DLB for the resection of subglottic cysts, dilation of tracheal stenosis, and visualization of complete tracheal rings. We believe that the 3D view offers qualitatively improved depth perception, accuracy of balloon placement, and appraisal of subglottic cyst resection margins. Conclusions and Relevance:This emerging technology has vast potential for improving endoscopy, surgical precision in airway interventions, tissue preservation, and methods of teaching. More research is needed in this area regarding the benefits and advantages of 3D compared with 2D endoscopy.

Visualization of the Supraglottis in Laryngomalacia With 3-Dimensional Pediatric Endoscopy

“…The surgical robot and its resulting 3D view or the newer applications of 3D endoscopy are used in gynecology, general surgery, neurosurgery, and otolaryngology. [6][7][8][9][10][11][12][13][14][15][16] The use of 3D technology has been shown to increase the speed with which novice surgeons are trained to perform laparoscopy with the ability to decrease errors in complex tasks. 12 A recent systematic review 7 also described a decrease in errors and an increase in speed by surgeons using 3D laparoscopy when compared with 2D laparoscopy in simulated environments.…”

“…The use of 3D endoscopy has also been described to improve visualization of complicated airway lesions. 15 At present, whether 3D visualization is superior to standard endoscopy to assess and manage complex airway lesions surgically is unclear. In pediatrics, supraglottoplasty to treat laryngomalacia is one of the most common laryngeal surgical procedures performed.…”

Dysphagia in head and neck cancer: A review

“…Most recently, endoscopy has been developed as a 3D modality. Reference [11] demonstrated that 3D endoscopy provided superior visualization over conventional 2D endoscopy in a case series. While this technology is primarily geared toward surgical use, as familiarity increases and cost decreases, it has the potential to become a diagnostic tool.…”

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

“…Although the literature describes the benefits of using a high‐definition (HD) 3D endoscope in endonasal and skull base surgery, and although it is quite well established in laparoscopic surgery, 3D technology was not used for laryngoscopic procedures until now. There is only one case study that examines the use of 3D endoscopy in evaluation and treatment; it describes three patients with subglottic and tracheal pathology and the unique inherent advantages of 3D compared with conventional 2D endoscopy . With this exception, there is no literature about the use of 3D endoscopy or 3D stroboscopy in laryngology.…”

“…There is only one case study that examines the use of 3D endoscopy in evaluation and treatment; it describes three patients with subglottic and tracheal pathology and the unique inherent advantages of 3D compared with conventional 2D endoscopy. 28 With this exception, there is no literature about the use of 3D endoscopy or 3D stroboscopy in laryngology. Previous development approaches did not go beyond the experimental stage due to the significant technical difficulties associated with the application and because of unavailable or too expensive technologies.…”