Management of difficult suspension laryngoscopy using a GlideScope® Video Laryngoscope

Abstract

Conclusions: The GlideScope® Video Laryngoscope (GVL) provides a successful method for obtaining adequate visualization of the larynx in patients with difficult laryngeal exposure (DLE). Although the GVL is far from an ideal laryngoscope for laryngeal surgery because of its low image quality and narrow curved operation space, valuable concepts regarding its development can be used for designing a new laryngoscope specifically for otolaryngology. Objective: DLE is a problem characterized by poor visualization of the larynx due to a combination of anatomic and clinical conditions. With respect to DLE, no consensus has been reached as to which alternative method should be used when direct laryngoscopy fails. This study focused on the management of DLE cases using the GVL to achieve adequate laryngeal exposure for phonosurgery. Methods: We used the GVL in conjunction with a set of specially designed endolaryngeal instruments in six cases for which traditional rigid laryngoscopy could not provide visualization of the larynx. Results: Using the GVL, full visualization of the larynx was obtained in all patients with minimal need for excessive internal or external pressure. Manipulations to remove simple lesions or perform a biopsy were carried out successfully. All of the surgeries were completed with excellent visualization and without any major complications.

Keywords::

• Laryngoscope
• difficult laryngeal exposure
• laryngoscopic surgical procedures

Acknowledgments

This study was supported by grant no. 07XI2-035 from the Shanghai Municipal Economic and Informatization Commission's Absorption and Re-innovation of Imported Technology Plan, and partly supported by the National Natural Science Foundation of China (no. 81028004). The authors thank Ellen Rose Conroy of the University of Wisconsin, School of Medicine, for writing assistance.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.