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Journal articles on the topic 'Indirect laryngoscopy'

Author: Grafiati

Published: 4 June 2021

Last updated: 12 February 2022

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1

Yi, In Kyong, Jihoon Hwang, Sang Kee Min, Gang Mee Lim, and Yun Jeong Chae. "Comparison of learning direct laryngoscopy using a McGrath videolaryngoscope as a direct versus indirect laryngoscope: a randomized controlled trial." Journal of International Medical Research 49, no. 5 (May 2021): 030006052110167. http://dx.doi.org/10.1177/03000605211016740.

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Objective Tracheal intubation using a direct laryngoscope is difficult to teach. The McGrath videolaryngoscope, a Macintosh-like device with a camera, can be used as a direct laryngoscope to educate novices under supervision using the screen. We compared the effect on Macintosh laryngoscopy skills following training with a McGrath videolaryngoscope as a direct versus indirect laryngoscope. Methods Thirty-seven participants were randomized into direct and indirect groups according to the training method using a McGrath videolaryngoscope. Participants attempted Macintosh direct laryngoscopy in normal and difficult airway scenarios. The primary endpoint was the intubation time, and the rate of successful intubation, dental trauma, and difficulty were secondary outcomes. Results The intubation time after education decreased significantly in both groups and was significantly shorter in the direct group than in the indirect group across time. The difficulty degree in the direct group was lower than that in the indirect group across time; however, the rate of dental trauma was not significantly different. Conclusion Both direct and indirect laryngoscopy using a McGrath videolaryngoscope improved the performance of Macintosh direct laryngoscopy in novices, while direct laryngoscopy using a McGrath videolaryngoscope demonstrated better educational effects than indirect laryngoscopy. Registered at ClinicalTrials.gov (NCT03471975).

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Korzan, G. J. "Indirect laryngoscopy." Canadian Medical Association Journal 186, no. 5 (March 17, 2014): 372. http://dx.doi.org/10.1503/cmaj.114-0018.

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3

Viernes, Darwin, Allan J. Goldman, Richard E. Galgon, and Aaron M. Joffe. "Evaluation of the GlideScope Direct: A New Video Laryngoscope for Teaching Direct Laryngoscopy." Anesthesiology Research and Practice 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/820961.

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Background. Teaching direct laryngoscopy is limited by the inability of the instructor to simultaneously view the airway with the laryngoscopist. Our primary aim is to report our initial use of the GlideScope Direct, a video-enabled, Macintosh laryngoscope intended primarily as a training tool in direct laryngoscopy.Methods. The GlideScope Direct was made available to anyone who planned on performing direct laryngoscopy as the primary technique for intubation. Novices were those who had performed <30 intubations.Results. The GlideScope Direct was used 123 times as primarily a direct laryngoscope while the instructor viewed the intubation on the monitor. It was highly successful as a direct laryngoscope (93% success). Salvage by indirect laryngoscopy occurred in 7/9 remaining patients without changing equipment. Novices performed 28 intubations (overall success rate of 79%). In 6 patients, the instructor took over and successfully intubated the patient. Instructors used the video images to guide the operator in 16 (57%) of those patients. Seven different instructors supervised the 28 novices, all of who subjectively felt advantaged by having the laryngoscopic view available.Conclusions. The GlideScope Direct functions similarly to a Macintosh laryngoscope and provides the instructor subjective reassurance, while providing the ability to guide the trainee laryngoscopist.

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Raimann, Florian Jürgen, Philipp Edmund Dietze, Colleen Elizabeth Cuca, Dirk Meininger, Paul Kessler, Christian Byhahn, Daniel Gill-Schuster, Kai Zacharowski, and Haitham Mutlak. "Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM® with Macintosh Blade and D-Blade® in a Simulated Difficult Airway." Emergency Medicine International 2019 (April 1, 2019): 1–8. http://dx.doi.org/10.1155/2019/1067473.

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Objective. Evaluation of C-MAC PM® in combination with a standard Macintosh blade size 3 in direct and indirect laryngoscopy and D-Blade® in indirect laryngoscopy in a simulated difficult airway. Primary outcome was defined as the best view of the glottic structures. Secondary endpoints were subjective evaluation and assessment of the intubation process. Methods. Prospective monocentric, observational study on 48 adult patients without predictors for difficult laryngoscopy/tracheal intubation undergoing orthopedic surgery. Every participant preoperatively received a cervical collar to simulate a difficult airway. Direct and indirect laryngoscopy w/o the BURP maneuver with a standard Macintosh blade and indirect laryngoscopy w/o the BURP maneuver using D-Blade® were performed to evaluate if blade geometry and the BURP maneuver improve the glottic view as measured by the Cormack-Lehane score. Results. Using a C-MAC PM® laryngoscope, D-Blade® yielded improved glottic views compared with the Macintosh blade used with either the direct or indirect technique. Changing from direct laryngoscopy using a Macintosh blade to indirect videolaryngoscopy using C-MAC PM® with D-Blade® improved the Cormack-Lehane score from IIb, III, or IV to I or II in 31 cases. Conclusion. The combination of C-MAC PM® and D-Blade® significantly enhances the view of the glottis compared to direct laryngoscopy with a Macintosh blade in patients with a simulated difficult airway. Trial Registration Number. This trial is registered under number NCT03403946.

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GOLZ, A., S. ZOHAR, S. AVRAHAM, and H. Z. JOACHIMS. "Indirect Microscopic Laryngoscopy." Archives of Otolaryngology - Head and Neck Surgery 115, no. 8 (August 1, 1989): 994. http://dx.doi.org/10.1001/archotol.1989.01860320104031.

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6

Calhoun, K. H., C. M. Stiernberg, F. B. Quinn, and W. D. Clark. "Teaching Indirect Mirror Laryngoscopy." Otolaryngology–Head and Neck Surgery 100, no. 1 (January 1989): 80–82. http://dx.doi.org/10.1177/019459988910000114.

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Indirect mirror laryngoscopy is difficult to learn. An anatomic model of the oropharynx and larynx is described here. This model is used to familiarize medical students with the component skills of mirror laryngoscopy. The students progress to competency at mirror laryngoscopy on patients more quickly after initial use of this model.

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7

Sánchez-Morillo, Jorge, María J. Estruch-Pérez, Maria J. Hernández-Cádiz, José M. Tamarit-Conejeros, Lorena Gómez-Diago, and Maite Richart-Aznar. "Indirect Laryngoscopy With Rigid 70-Degree Laryngoscope as a Predictor of Difficult Direct Laryngoscopy." Acta Otorrinolaringologica (English Edition) 63, no. 4 (July 2012): 272–79. http://dx.doi.org/10.1016/j.otoeng.2012.07.003.

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8

Shulman, G. Brent, Ned G. Nordin, and Neil Roy Connelly. "Teaching with a Video System Improves the Training Period but Not Subsequent Success of Tracheal Intubation with the Bullard Laryngoscope." Anesthesiology 98, no. 3 (March 1, 2003): 615–20. http://dx.doi.org/10.1097/00000542-200303000-00007.

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Background The Bullard laryngoscope is useful for the management of a variety of airway management scenarios. Without the aid of a video system, teaching laryngoscopy skills occurs with indirect feedback to the instructor. The purpose of this study was to determine if use of a video system would speed the process of learning the Bullard laryngoscope or improve the performance (speed or success) of its use. Methods Thirty-six anesthesia providers with no previous Bullard laryngoscope experience were randomly divided into two groups: initial training (first 15 intubations) with looking directly through the eyepiece (n = 20), or with the display of the scope on a video monitor (n = 16). The subjects each then performed 15 Bullard intubations by looking directly through the eyepiece. Results There was not an overall significant difference in laryngoscopy or intubation times between the groups. When only the first 15 intubations were considered, the laryngoscopy time was shorter in the video group (26 +/- 24) than in the nonvideo group (32 +/- 34; P< 0.04). In the first 15 patients, there were fewer single attempts at intubation (67.9% vs 80.3%; P< 0.002) and more failed intubations (17.2% vs 6.0%; P< 0.0001) in the nonvideo group. Conclusions In conclusion, the authors have shown that use of a video camera decreases time for laryngoscopic view and improves success rate when the Bullard laryngoscope is first being taught to experienced clinicians. However, these benefits are not evident as more experience with the Bullard laryngoscope is achieved, such that no difference in skill with the Bullard laryngoscope is discernible after 15 intubations whether a video system was used to teach this technique.

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Pieters, B. M., G. B. Eindhoven, C. Acott, and A. A. J. Van Zundert. "Pioneers of Laryngoscopy: Indirect, Direct and Video Laryngoscopy." Anaesthesia and Intensive Care 43, no. 1_suppl (July 2015): 4–11. http://dx.doi.org/10.1177/0310057x150430s103.

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10

Yamamoto, Ken, Tsunehisa Tsubokawa, Keizo Shibata, Shigeo Ohmura, Shunichi Nitta, and Tsutomu Kobayashi. "Predicting Difficult Intubation with Indirect Laryngoscopy." Anesthesiology 86, no. 2 (February 1, 1997): 316–21. http://dx.doi.org/10.1097/00000542-199702000-00007.

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Background It is not always possible to predict when tracheal intubation will be difficult or impossible. The authors wanted to determine whether indirect laryngoscopy could identify patients in whom intubation was difficult. Methods Indirect laryngoscopy was done in 2,504 patients. The Wilson risk sum score and the modified Mallampati score were also studied in a different series of 3,680 patients for comparison. These predictive methods were compared according to three parameters: positive predictive value, sensitivity, and specificity. Results Of 6,184 patients studied, the trachea proved difficult to intubate in 82 (1.3%). Positive predictive value (31%) and specificity (98.4%) with indirect laryngoscopy were greater than the other two predictive methods (P < 0.01), whereas sensitivity with indirect laryngoscopy (69.2%) was greater than that of the Wilson risk sum score (55.4%) (P < 0.01). Conclusions Although in 15% of patients indirect laryngoscopy could not be performed because of excessive gag reflex, indirect laryngoscopy can serve as an effective method to predict difficult intubation.

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11

Mani, N., and D. Lowe. "Indirect laryngoscopy ? the cold way." Clinical Otolaryngology 32, no. 2 (April 2007): 138–39. http://dx.doi.org/10.1111/j.1365-2273.2007.01316.x.

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12

Hobson, J. C., and A. Cardozo. "Indirect laryngoscopy - the cold way." Clinical Otolaryngology 32, no. 6 (December 7, 2007): 492. http://dx.doi.org/10.1111/j.1749-4486.2007.01521.x.

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13

Al-Helo, Sajad, Ahmed Al-Safi, and Rahma Aljanabi. "Role of videolaryngostroboscopy in the diagnosis of dysphonic patient with normal fiberoptic laryngoscopy." Iraqi National Journal of Medicine 3, no. 1 (January 15, 2021): 26–38. http://dx.doi.org/10.37319/iqnjm.3.1.3.

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Background: Dysphonia is altered voice quality, pitch, loudness, or vocal effort that impairs people’s quality of life. It is a very common complaint affecting nearly one-third of a population at some point in their life and could be caused by infection, tumor, trauma, vocal cord paralysis, etc . Indirect mirror or endoscopic laryngoscopy is used to assess the laryngeal condition in dysphonic patients seeking mainly for the cause, but frequently the findings were normal or unremarkable . Videolaryngoscopy (VLS) is very useful in dysphonic patients who have an otherwise normal indirect or flexible laryngoscopic examination. In addition to providing information regarding vocal fold vibrations, the image obtained through VLS can be magnified to make a more detailed assessment of the vocal cord anatomy than is possible with rigid of flexible laryngoscopy. Objective of study: To assess the videolaryngostroboscopic findings in dysphonic patients with normal fiber-optic laryngoscopy. Patient & Method: A cross-sectional study, Fifty patients were included in the study; They had complained of dysphonia, and the fiber-optic laryngoscopic examination was normal. Videostroboscopy were obtained for all patients to assess vocal fold vibration and seek any abnormal findings. Results: A total of 50 patients were enrolled in this study. Regarding the stroboscopic findings, 42% of the patients were normal, 15 (30%) had early soft singer’s nodules, 6 patients (12%) had intracordal lesions, 4 patients (8%)had vocal cord polypoidal changes, 2 patients (4%) had presbylaryngis, and the other 2 patients (4%) had sulcus vocalis. Conclusion: VLS is beneficial in detecting vocal cord lesions in patients with normal fiber-optic laryngoscopy. A high proportion (more than half) of dysphonic patients with normal fiber-optic laryngoscopy had abnormal findings. Keywords: Stroboscopy, Videolaryngoscopy, Fiberoptic laryngoscopy, Dysphonia.

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Friedrich, Gerhard, Karl Kiesler, and Markus Gugatschka. "Curved rigid laryngoscope: missing link between direct suspension laryngoscopy and indirect techniques?" European Archives of Oto-Rhino-Laryngology 266, no. 10 (April 7, 2009): 1583–88. http://dx.doi.org/10.1007/s00405-009-0974-z.

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McGuire, Barry E., and Rhona A. Younger. "Rigid indirect laryngoscopy and optical stylets." Continuing Education in Anaesthesia Critical Care & Pain 10, no. 5 (October 2010): 148–51. http://dx.doi.org/10.1093/bjaceaccp/mkq027.

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C.P., Sudheer, Anoop M, Majid Khan, Laxman B, Kathyayani B, and Abdul Aziz. "INDIRECT LARYNGOSCOPY – HYDROGEN PEROXIDE AS DEFOGGER." Journal of Evolution of Medical and Dental sciences 2, no. 49 (December 3, 2013): 9532–33. http://dx.doi.org/10.14260/jemds/1654.

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Khan, Rabia Zaman, Asim Iqbal, and Ghulam Saqulain. "Diagnostic Accuracy of Fiber Optic Laryngoscopy." Journal of Islamabad Medical & Dental College 10, no. 2 (June 29, 2021): 101–4. http://dx.doi.org/10.35787/jimdc.v10i2.426.

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Background: Laryngeal examination of patients with hoarseness is essential to diagnose a wide range of pathologies. Laryngeal visualization has progressed from simple indirect mirror examination to virtual laryngoscopy with flexible fiber optic laryngoscope as an acceptable option. This study was done to determine the diagnostic accuracy of fiber optic laryngoscopy in patients with hoarseness.Material and Methods: This cross-sectional comparative study included a sample of 155 participants, of both genders, aged 20 to 60 years with hoarseness of at least 1 month duration. Participants were recruited through non probability consecutive sampling technique from ENT department, Sir Ganga Ram Hospital Lahore, Pakistan over a period of six months (October 2015 to March 2016). Patients fulfilling the selection criteria were subjected to Fiber Optic Laryngoscopy (FOL) under local anesthesia followed by Direct Laryngoscopy (DL) under general anesthesia and findings recorded. Data was collected, tabulated and analyzed using SPSS 17. Diagnostic value of FOL versus DL was calculated with frequency, percentage, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).Results: Out of 155 participants, 48.39 % (75) were males and 51.61 % (80) females, with mean age of 31 ± 9.54 years. Assessment of diagnostic accuracy of fiber optic laryngoscopy taking direct laryngoscopy as criterion standard showed an accuracy of 80.65% with 89.19% sensitivity, 77.96% specificity, 55.93% PPV, and 95.83% NPV.Conclusions: Fiber optic laryngoscopy is an excellent tool for the diagnosis of hoarseness, with a diagnostic accuracy of 80.65%.

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Collins, S. R. "Direct and Indirect Laryngoscopy: Equipment and Techniques." Respiratory Care 59, no. 6 (June 1, 2014): 850–64. http://dx.doi.org/10.4187/respcare.03033.

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Vaidya, Sudhakar, R. S. Pagare, S. K. Jethaliya, and V. K. Sharma. "Hydrogen peroxide as ‘defogger’ in indirect laryngoscopy." Indian Journal of Otolaryngology and Head & Neck Surgery 59, no. 3 (September 2007): 303–4. http://dx.doi.org/10.1007/s12070-007-0089-z.

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Labadi, Monther H., and Musa N. Jamal. "Leeches in the larynx." Journal of Laryngology & Otology 111, no. 10 (October 1997): 980–81. http://dx.doi.org/10.1017/s0022215100139131.

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AbstractThis is a report of two patients with leech inhalation. The first patient presented with severe attacks of inspiratory stridor, cyanosis and cough of five days duration. He had no fever. Indirect laryngoscopy revealed a black, smooth foreign body between the vocal folds. Lateral soft tissue X-ray of the neck revealed shadow involving the glottic and the subglottic areas of the larynx. Laryngoscopy under general anaesthesia showed a living leech. This was removed and the patient improved.The second patient presented with difficulty of breathing, dysphagia, and spitting of blood of two weeks duration. Indirect laryngoscopy revealed a brown foreign body in the larynx. Laryngoscopy under general anaesthesia showed a living leech. This was removed by forceps.

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Benjamin, Bruce, Christopher Dalton, and Glen Croxson. "Laryngoscopic Diagnosis of Laryngeal Sarcoid." Annals of Otology, Rhinology & Laryngology 104, no. 7 (July 1995): 529–31. http://dx.doi.org/10.1177/000348949510400705.

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Sarcoidosis is usually a multisystem granulomatous disease, and it sometimes affects the larynx and causes symptoms of dysphonia, dyspnea, and dysphagia. Laryngeal sarcoid has a characteristic appearance at direct or indirect laryngoscopy: the supraglottic tissues are symmetrically affected with a pale, diffusely swollen appearance somewhat like that of epiglottitis. Five cases of laryngeal sarcoid are presented. Three photographs taken at direct laryngoscopy, and one at indirect laryngoscopy, document and emphasize the typical appearance of the supraglottic tissues. The appearance of this uncommon condition is sufficiently characteristic to suggest the diagnosis, which can finally be confirmed only by biopsy.

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Chandail, Vijant Singh, Vinu Jamwal, and J. Paul Kanotra. "Direct Laryngoscopy Using a Videogastroscope : A New Technique." Journal of Digestive Endoscopy 02, no. 01 (January 2011): 006–8. http://dx.doi.org/10.1055/s-0039-1700252.

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ABSTRACT Background and objectives: Although indirect laryngoscopy is commonly used method for evaluation of laryngeal disorders in outpatient Ear, Nose and Throat Department (ENT) but proper and accurate diagnosis is not possible in every patient. The direct laryngoscopy using fiberoptic- or video- laryngoscopy has been shown to be a valuable tool in the examination of laryngeal and supraglottic anatomy and pathology. Our goal was to develop a new diagnostic method wherein direct laryngoscopy can be performed by videogastroscope which unlike fiberoptic- or video- laryngoscopy, is readily available at most of the centres. Methods: Between May 2009 and December 2009, 1462 consecutive patients underwent indirect laryngoscopy for evaluation of laryngeal disorders at ENT outpatient department. Fifty-two (93.6%) consecutive patients who had unsuccessful, inconclusive or incomplete examination underwent direct laryngoscopy with videogastroscope. Results: The study group consisted of 39 males and 13 females with mean age of 34.8 ± 11 years (range 14 to 58 years). The following abnormalities were found in vocal cords in 31 (59.6%) patients: cancer in 8 patients; leukoplakia, 6; cases, nodules, 6; palsy, 5; epitheloid granuloma, 2; submucosal hemorrhages, 2; and polyp in 2. Conclusions: Direct laryngoscopy using videogastroscope is safe, feasible and highly accurate for the diagnosis of laryngeal disorders.( J Dig Endos2011;2(1):6-8)

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Lapeña, Jose Florencio. "Mirrors and Reflections: The Evolution of Indirect Laryngoscopy." Annals of Saudi Medicine 33, no. 2 (April 2013): 177–81. http://dx.doi.org/10.5144/0256-4947.2013.177.

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Puchner, Wolfgang, Lukas Drabauer, Klemens Kern, Charlotte Mayer, Jan Bierbaumer, Peter H. Rehak, and Hans Gombotz. "Indirect versus direct laryngoscopy for routine nasotracheal intubation." Journal of Clinical Anesthesia 23, no. 4 (June 2011): 280–85. http://dx.doi.org/10.1016/j.jclinane.2010.10.003.

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Oh, Ji Youn, Ji Hye Lee, Yu Yil Kim, Seung Min Baek, Da Wa Jung, and Ji Hun Park. "A comparative study of glottis visualization according to the method of lifting the epiglottis in video laryngoscopy: indirect and direct lifting methods." Anesthesia and Pain Medicine 16, no. 2 (April 30, 2021): 196–200. http://dx.doi.org/10.17085/apm.20073.

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Background: The direct entry of the camera under the epiglottis may provide a better view of the glottis than the indirect lifting of the epiglottis by placing the Macintosh blade tip on the vallecula when using the video laryngoscope. This study aimed to compare the efficiency of two different methods of lifting the epiglottis during the visualization of glottis using video laryngoscopy in the same patient.Methods: This prospective study enrolled 60 patients who underwent general anesthesia with tracheal intubation. In each patient, glottic views were obtained by directly (group DE) and indirectly lifting the epiglottis (group IE). These two methods were compared using the modified Cormack and Lehane grade and the percentage of glottis opening (POGO) score as assessment parameters.Results: Modified Cormack and Lehane grade showed a significant difference between the groups DE and IE (P = 0.004). The difference in the POGO score between the groups DE and IE was also statistically significant (87.5% and 64.4%, respectively; P < 0.001).Conclusions: Our results, therefore, revealed that the method of directly lifting epiglottis was better at exposing glottis than the method of indirectly lifting epiglottis using a video laryngoscope.

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Gordon, Joanna K., Vaughan E. Bertram, Francesco Cavallin, Matteo Parotto, and Richard M. Cooper. "Direct versus indirect laryngoscopy using a Macintosh video laryngoscope: a mannequin study comparing applied forces." Canadian Journal of Anesthesia/Journal canadien d'anesthésie 67, no. 5 (March 9, 2020): 515–20. http://dx.doi.org/10.1007/s12630-020-01583-x.

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Casiano, Roy R., Vijaykumar Zaveri, and Donna S. Lundy. "Efficacy of Videostroboscopy in the Diagnosis of Voice Disorders." Otolaryngology–Head and Neck Surgery 107, no. 1 (July 1992): 95–100. http://dx.doi.org/10.1177/019459989210700115.

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While videostrobolaryngoscopy is not a new technique, its acceptance as a routine part of the voice evaluation has not been as forthcoming. Many are in agreement that the rigid fiberoptic telescopes in combination with standard VHS equipment provide a clear, magnified image that can be recorded and used for pretreatment and post-treatment comparisons, documentation, teaching, and research. Yet, some skepticism persists with regard to the ability of videolaryngoscopy and/or videostrobolaryngoscopy in changing the diagnosis and treatment outcome of patients with voice disorders as compared to indirect laryngoscopy. Two hundred ninety-two dysphonic patients were identified who underwent indirect as well as videolaryngoscopy with and without stroboscopic examination. Videostrobolaryngoscopy was found to alter the diagnosis and treatment outcome in 14% of the patients. It is most useful in patients with a diagnosis of functional dysphonia and vocal fold paralysis by indirect laryngoscopy. The increased illumination and magnification afforded by rigid fiberoptic telescopes during videolaryngoscopy, combined with the detailed assessment of glottic closure, mucosal wave, and amplitude characteristics provided by stroboscopic examination, allowed detection of subtle vocal fold pathology, otherwise missed by indirect laryngoscopy.

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Ford, Charles N. "The technique of indirect laryngoscopy for botulinum toxin injection." Operative Techniques in Otolaryngology-Head and Neck Surgery 4, no. 3 (September 1993): 191–95. http://dx.doi.org/10.1016/s1043-1810(10)80189-7.

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Taylor, W. C. "Indirect laryngoscopy as a screening test for laryngeal cancer." JAMA: The Journal of the American Medical Association 265, no. 22 (June 12, 1991): 3011. http://dx.doi.org/10.1001/jama.265.22.3011.

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Li, Hui-Xian, Fu-Shan Xue, Ya-Yang Liu, and Gui-Zhen Yang. "Comparing direct and indirect laryngoscopy: Study design is crucial." Journal of Clinical Anesthesia 38 (May 2017): 22–23. http://dx.doi.org/10.1016/j.jclinane.2017.01.019.

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Choy, A. T. K., P. G. C. Gluckman, M. C. F. Tong, and C. A. Van Hasselt. "Flexible nasopharyngoscopy for fish bone removal from the pharynx." Journal of Laryngology & Otology 106, no. 8 (August 1992): 709–11. http://dx.doi.org/10.1017/s002221510012064x.

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AbstractThe use of flexible nasopharyngoscopy with biopsy forceps for the removal of fish bones found in the oropharynx and hypopharynx is described. One hundred and sixty-eight patients with ingested fish bones in the upper aero-digestive tract were studied over a 12-month period. Of these, 73 percent were removed per-orally, or by indirect laryngoscopy. Fifteen percent were removed using the fibreoptic nasopharyngoscope. Twelve percent required a general anaesthetic and rigid oesophagoscopy for removal of fish bones at or below the level of the cricopharyngeus muscle. The technique has proven to be quick, well tolerated and low in morbidity. It is invaluable in patients in whom indirect laryngoscopy is unsatisfactory.

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Onrubia, X., L. Narváez, T. Cárcel, R. Higueras, J. Martin, L. Maiza, and I. Renart. "Standard direct versus indirect laryngoscopy with McGRATH™ MAC video laryngoscope, our experience and degree of satisfaction." Trends in Anaesthesia and Critical Care 16 (October 2017): 19. http://dx.doi.org/10.1016/j.tacc.2017.10.025.

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Bastian, Robert W., and Kathelijne G. Delsupehe. "Indirect Larynx and Pharynx Surgery: A Replacement for Direct Laryngoscopy." Laryngoscope 106, no. 10 (October 1996): 1280–86. http://dx.doi.org/10.1097/00005537-199610000-00022.

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Niedermeier, Bruno, Fernando Portinho, and Carlos Silva. "Reflux Laryngitis: Correlation between the Symptoms Findings and Indirect Laryngoscopy." International Archives of Otorhinolaryngology 19, no. 03 (January 9, 2015): 234–37. http://dx.doi.org/10.1055/s-0034-1399794.

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Parotto, Matteo, and Richard Cooper. "Recent advances in laryngoscopy in adults." F1000Research 8 (June 6, 2019): 797. http://dx.doi.org/10.12688/f1000research.18544.1.

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Recent advances in technology have made laryngoscopy less dependent upon a direct line of sight to achieve tracheal intubation. Whether these new devices are useful tools capable of increasing patient safety depends upon when and how they are used. We briefly consider the challenges in reviewing the emerging literature given the variety of devices, “experience” of the care providers, the clinical settings, and the definitions of outcome. We examine some of the limitations of conventional direct laryngoscopy, question the definitions we have used to define success, discuss the benefits of indirect (video) techniques, and review evidence pertaining to their use in the patients in the operating room, emergency department, and intensive care unit.

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Sánchez-Morillo, Jorge, Lorena Gómez-Diago, Pablo Rodríguez-Gimillo, Raúl Herrera-Collado, Jorge Puchol-Castillo, and Luis Mompó-Romero. "Airway Evaluation by Indirect Laryngoscopy in Patients With Lingual Tonsillar Hypertrophy." Acta Otorrinolaringologica (English Edition) 64, no. 5 (September 2013): 345–51. http://dx.doi.org/10.1016/j.otoeng.2013.10.010.

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Yeung, Philip, Catherine Erskine, Philip Mathews, and PHILIP J. Crowe. "VOICE CHANGES AND THYROID SURGERY: IS PRE-OPERATIVE INDIRECT LARYNGOSCOPY NECESSARY?" ANZ Journal of Surgery 69, no. 9 (September 1999): 632–34. http://dx.doi.org/10.1046/j.1440-1622.1999.01653.x.

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38

Estruch-Perez, M. J., M. J. Hernandez-Cadiz, L. Gomez-Diago, J. Balaguer-Domenech, J. Sanchez-Morillo, and C. Solaz-Roldan. "Indirect laryngoscopy as a predictor of difficult visualization of the larynx." European Journal of Anaesthesiology 29 (June 2012): 237–38. http://dx.doi.org/10.1097/00003643-201206001-00790.

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39

Ravi Kishore, H., and Pallavi Hosakoti. "Relevance of indirect laryngoscopy as an examination tool in present day otorhinolaryngological practice." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 6 (May 22, 2020): 1125. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20202212.

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<p class="abstract"><strong>Background:</strong> The objective of the study was to determine the difference in extent of laryngeal visualization between indirect laryngoscopy (IDL) mirror and rigid endoscopy (70°) and relevance of IDL in present day otolaryngological practice.</p><p class="abstract"><strong>Methods:</strong> 100 patients attending to the Department of ENT, Vijayanagara Institute of Medical Sciences, Ballari, Karnataka with complaints referable to larynx and upper digestive tract were taken up for study. All patients underwent IDL mirror and rigid endoscopic (4 mm, 70°) examination. The extent of laryngeal visualization by the clinician was recorded for each examination. </p><p class="abstract"><strong>Results:</strong> Out of 100 patients who underwent IDL mirror examination and rigid endoscopic (4 mm, 70°) examination in 87% of cases IDL mirror examination was adequate for making the diagnosis and in 11% of cases we needed rigid endoscopic examination for making the diagnosis. In 2% of cases we were not able to visualize the pathologies even with rigid endoscopy, in whom we needed other modalities of examination like radiological evidence to arrive at a diagnosis.</p><p class="abstract"><strong>Conclusions:</strong> In the present study, in 87% of the cases IDL mirror examination was adequate for making the diagnosis. Eleven cases needed rigid endoscopic (4 mm, 70°) examination to aid in diagnosis of pathologies. Even though laryngeal mirror examination is less comfortable, causing gagging for patient and may provide less complete information when compared to rigid endoscopy because of its less expensive, better depth visualization of structures and near real size images provides a versatile tool till date. Be that as it may indirect laryngoscopic mirror examination remains the mainstay of otolaryngological practice in today’s Otolaryngology practice.</p>

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Naha, Abirvab, Utpal Dutta, Pran Gopal Datta, Ashim Kumar Biswas, and MA Chowdhury. "White papilloma involving both vocal cords: A Case Report." Bangladesh Journal of Otorhinolaryngology 26, no. 1 (July 1, 2020): 73–76. http://dx.doi.org/10.3329/bjo.v26i1.47957.

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White papilloma are rare lesions that may occur at any site of mucosa- lined respiratory tract especially in vocal cords. Morphologically it appears villas looking, clinically & microscopically benign in most cases. We report a 70 years old male patient with white papilloma near anterior commissure involving both vocal cords found during indirect laryngoscopy. The lesion was completely resected with a unipolar coagulation device under direct laryngoscopy. Histopathological examination showed papilloma of vocal cords associated with Human papilloma virus(HPV) wart. To our knowledge this is the second reported case concomitant white papilloma with concomitant HPV in the vocal cords. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 73-76

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Ghabash, M. B., M. S. Matta, and P. Choueiry. "Use of the mirror of indirect laryngoscopy for detection of esophageal intubation." Acta Anaesthesiologica Scandinavica 41, no. 7 (August 1997): 950. http://dx.doi.org/10.1111/j.1399-6576.1997.tb04817.x.

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42

Arens, C., D. Reußner, J. Woenkhaus, A. Leunig, C. S. Betz, and H. Glanz. "Indirect fluorescence laryngoscopy in the diagnosis of precancerous and cancerous laryngeal lesions." European Archives of Oto-Rhino-Laryngology 264, no. 6 (February 10, 2007): 621–26. http://dx.doi.org/10.1007/s00405-007-0251-y.

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Saldanha, Darrel, Vijay Krishnamoorthy, Priscilla Hensel, Mark Mueller, Charles I. Laurito, and Guy Weinberg. "Preoperative indirect mirror laryngoscopy used as means of predicting a difficult airway." Journal of Clinical Anesthesia 25, no. 3 (May 2013): 250. http://dx.doi.org/10.1016/j.jclinane.2013.03.005.

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Jung, Axel, Johannes Schramm, Kai Lehnerdt, and Claus Herberhold. "Recurrent laryngeal nerve palsy during anterior cervical spine surgery: a prospective study." Journal of Neurosurgery: Spine 2, no. 2 (February 2005): 123–27. http://dx.doi.org/10.3171/spi.2005.2.2.0123.

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Object. Recurrent laryngeal nerve (RLN) palsy is a well-known complication of cervical spine surgery. Nearly all previous studies were performed without laryngoscopy in asymptomatic patients. This prospective study was undertaken to discern the true incidence of RLN palsy. Because not every RLN palsy is associated with hoarseness, the authors conducted a prospective study involving the use of pre- and postoperative laryngoscopy. Methods. Prior to anterior cervical spine surgery preoperative indirect laryngoscopy was performed in 123 patients to evaluate the status of the vocal cords as a sign of function of the RLN. To assess postoperative status in 120 patients laryngoscopy was repeated, and in cases of vocal cord malfunction follow-up examination was conducted 3 months later. In the group of 120 patients who attended follow-up examination, two (1.6%) had experienced a preoperative RLN palsy without hoarseness. Postoperatively the rate of clinically symptomatic RLN palsy was 8.3%, and the incidence of RLN palsy not associated with hoarseness (that is, clinically unapparent without laryngoscopy) was 15.9% (overall incidence 24.2%). At 3-month follow-up evaluation the rate had decreased to 2.5% in cases with hoarseness and 10.8% without hoarseness. Thus, the overall rate of early persisting RLN palsy was 11.3%. Conclusions. Laryngoscopy revealed that the true incidence of initial and persisting RLN palsy after anterior cervical spine surgery was much higher than anticipated. Especially in cases without hoarseness this could be proven, but the initial incidence of hoarseness was higher than expected. Only one third of new RLN palsy cases could be detected without laryngoscopy. Resolution of hoarseness was approximately 70% in those with preoperative hoarseness. The true rate of RLN palsy underscores the necessity to reevaluate the surgery- and intubation-related techniques for anterior cervical spine surgery and to reassess the degree of presurgical patient counseling.

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Kim, Sung Mi, and Hyun Joo Kim. "Successful advancement of endotracheal tube with combined fiberoptic bronchoscopy and videolaryngoscopy in a patient with a huge goiter." SAGE Open Medical Case Reports 8 (January 2020): 2050313X2092323. http://dx.doi.org/10.1177/2050313x20923232.

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If the presence of a goiter causes airway deformities in the supraglottic and infraglottic areas, difficult airway should be considered and airway evaluation including physical examination, radiologic studies, and indirect laryngoscopy should be preoperatively performed to determine the airway management plan. Various methods such as direct laryngoscopy, videolaryngoscopy, awake fiberoptic intubation, tracheostomy, and extracorporeal membrane oxygenation support have been reported to secure the airway. In most previously reported goiter cases, the upper airway patency was well maintained and the endotracheal tube was easily passed even when there was severe tracheal narrowing and deviation. We describe a case of successful combined use of videolaryngoscopy and fiberoptic bronchoscopy for advancement of an endotracheal tube through a narrow trachea due to the presence of a huge goiter.

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Wittmann, F. W., and P. A. Ring. "Anaesthesia for Hip Replacement in Ankylosing Spondylitis." Journal of the Royal Society of Medicine 79, no. 8 (August 1986): 457–59. http://dx.doi.org/10.1177/014107688607900808.

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Thirteen total hip replacements in 8 patients with ankylosing spondylitis are reviewed. Complications of the disease which can lead to anaesthetic difficulties are discussed, and the importance of a preoperative visit and the value of indirect laryngoscopy emphasized. As intubation problems may occur, especially in undiagnosed cases, equipment for emergency intubation should always be readily available. The results fully justify the operation.

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Fleischer, Susanne, Christina Pflug, and Markus Hess. "Dipping and rotating: two maneuvers to achieve maximum magnification during indirect transnasal laryngoscopy." European Archives of Oto-Rhino-Laryngology 277, no. 5 (March 4, 2020): 1545–49. http://dx.doi.org/10.1007/s00405-020-05862-7.

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Arens, C., T. Dreyer, H. Glanz, and K. Malzahn. "Indirect autofluorescence laryngoscopy in the diagnosis of laryngeal cancer and its precursor lesions." European Archives of Oto-Rhino-Laryngology 261, no. 2 (February 1, 2004): 71–76. http://dx.doi.org/10.1007/s00405-003-0653-4.

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Krespi, Yosef P., Shaista Husain, Moises Mitrani, and Charles J. Meltzer. "Treatment of Laryngeal Sarcoidosis with Intralesional Steroid Injection." Annals of Otology, Rhinology & Laryngology 96, no. 6 (November 1987): 713–15. http://dx.doi.org/10.1177/000348948709600622.

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Laryngeal sarcoidosis presents with hoarseness, cough, and dysphagia. Shortness of breath due to upper airway obstruction may occur. Indirect laryngoscopy reveals mucosal edema and erythema, granulomas, and nodules. The supraglottic larynx is the most frequently affected area. Systemic corticosteroids can be used initially; however, with persistent symptoms and/or severe airway problems, intralesional steroid injections may be more effective, as in the six patients presented.

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Sánchez-Morillo, J., L. Gómez-Diago, M. J. Hernández-Cádiz, J. Balaguer-Doménech, G. Barber-Ballester, and M. Richart-Aznar. "Influence of pharyngolaryngeal anomalies diagnosed through indirect laryngoscopy in the prediction of difficult intubation." Revista Española de Anestesiología y Reanimación (English Edition) 62, no. 5 (May 2015): 245–52. http://dx.doi.org/10.1016/j.redare.2015.02.002.

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