Improved airway visualization during direct laryngoscopy using self-retaining laryngeal retractors: a quantitative study.

Objective: To measure the degree to which the Lindholm laryngeal distending forceps improve visualization during direct laryngoscopy in selected pediatric patients.Study Design: Case series with chart review.Setting: Pediatric hospital.Subjects and Methods: Subjects included children undergoing dire...

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Published in:Otolaryngology-Head & Neck Surgery Vol. 145; no. 2; pp. 270 - 276
Main Authors: Longstreet B, Bhama PK, Inglis AF Jr, Saltzman B, Perkins JA, Longstreet, Beck, Bhama, Prabhat K, Inglis, Andrew F Jr, Saltzman, Babette, Perkins, Jonathan A
Format: research Journal Article
Published: Wiley-Blackwell Aug2011
Online Access:View this record in EBSCOhost
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      dt: Aug2011
      vid: 145
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1177/0194599811405429
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        atl: Improved airway visualization during direct laryngoscopy using self-retaining laryngeal retractors: a quantitative study.
      aug:
        au:
          Longstreet B
          Bhama PK
          Inglis AF Jr
          Saltzman B
          Perkins JA
          Longstreet, Beck
          Bhama, Prabhat K
          Inglis, Andrew F Jr
          Saltzman, Babette
          Perkins, Jonathan A
        affil: University of Washington School of Medicine, Seattle, Washington, USA
      sug:
        subj:
          Laryngeal Diseases Diagnosis
          Endoscopes
          Laryngoscopy Methods
          Larynx Pathology
          Adolescence
          Child
          Child, Preschool
          Equipment Design
          Female
          Infant
          Male
          Reproducibility of Results
          Retrospective Design
          Young Adult
          Adolescent: 13-18 years
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Infant: 1-23 months
          Female
          Male
      ab: Objective: To measure the degree to which the Lindholm laryngeal distending forceps improve visualization during direct laryngoscopy in selected pediatric patients.Study Design: Case series with chart review.Setting: Pediatric hospital.Subjects and Methods: Subjects included children undergoing direct laryngoscopy using the Lindholm laryngeal distending forceps. Intraoperative endoscopic photos with and without false cord retraction via the Lindholm laryngeal distending forceps were obtained from the Seattle Children's Hospital airway endoscopy photo library. Analysis was performed using imaging software. Comparisons of visible vocal cord and glottic opening areas as well as anterior commissure angles with and without the Lindholm laryngeal distending forceps were performed with a paired and unpaired Student t test.Results: The use of the Lindholm laryngeal distending forceps increased the glottic opening by a mean of 359% (95% confidence interval [CI], 255%-463%) and increased visualized true vocal cord area by 337% (197%-477%). Angle at the anterior commissure increased from a mean of 24.9° to a mean of 71.5°, resulting in a net mean angle increase of 46.6° (95% CI, 40.2°-52.9°). All measured changes were statistically significant with P values <.01.Conclusions: When placed at the level of the false vocal folds, Lindholm laryngeal distending forceps will, at least in certain cases, greatly increase the visible area of the superior surface of the vocal folds, the anterior commissure, and, by increasing the glottic opening, the subglottic region. This improved visualization may enhance the surgeon's ability to diagnose and treat pathologies in these anatomic regions during direct laryngoscopy.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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