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Updated: Apr 24, 2026
Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
The 70-degree telescope as a teaching tool for cleft palate repair and pharyngoplasty surgery
Noel Jabbour1, Sivakumar Chinnadurai2, Christopher T Wootten2
1University of Pittsburgh Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, 4401 Penn Avenue Faculty Pavilion, 7th Floor, Pittsburgh, PA 15224, United States.
Objective:
To determine the optimum positioning of a 70-degree telescope to provide a maximum view of the palate and posterior pharynx for observers while minimally obstructing the direct view of a surgeon.
Design:
Simulator testing of clinical protocol.
Setting:
Simulation center of an academic tertiary care children's hospital.
Interventions:
The palate and pharynx of an infant airway mannequin was exposed with a Dingman mouthgag. A 4 mm, 70-degree endoscope was secured to the Mayo stand to provide a projected image of the simulated operative procedure. Various positions of the 70-degree telescope were photodocumented by manipulating the angle of the scope, the extension past the lower lip, and the distance of the scope tip away from the midline. Using a 4-point Likert scale, three surgeons rated the randomized photos from both the direct operative view and the projected endoscopic view.
Results:
Average rating for the adequacy of the view for pharyngeal surgery was 2.4/4.0 and for palate surgery was 3.1/4.0 (p=.001). Only 4 of 22 scope positions were rated as minimally obstructive to direct view by all three surgeons. Only 1 position--scope parallel and just lateral to the tongue blade--was rated as minimally obstructive and adequate for both pharyngeal and palatal surgery by all three surgeons.
Conclusions:
In training centers, a 70-degree telescope attached to a Mayo stand may be useful for teaching and assessing cleft palate and pharyngoplasty surgery, while providing minimal obstruction to direct view by the surgeon.
