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Transillumination for needle localization in the larynx.
Henry T Hoffman1, Seth H Dailey2, Jonathan M Bock3
1Department of Otolaryngology University of Iowa, Iowa City, Iowa.
The Laryngoscope
|May 29, 2015
Summary
This study demonstrates that using lighted fiberoptic cables within needles can accurately guide percutaneous placement in the larynx. This novel technique enhances precision for laryngeal procedures and injections.
Area of Science:
- Otolaryngology
- Minimally Invasive Surgery
- Laryngeal Anatomy
Background:
- Percutaneous needle placement in the larynx can be challenging due to soft tissue.
- Accurate localization is crucial for effective laryngeal interventions.
Purpose of the Study:
- To evaluate the feasibility of using transillumination for percutaneous needle placement in the larynx.
- To assess the efficacy of fiberoptic cables in guiding needle tips within laryngeal structures.
Main Methods:
- Cadaveric simulation using canine and human specimens.
- Testing of lighted devices (sialendoscopes, fiberoptic cables) within needles and trocars.
- Monitoring via flexible transnasal laryngoscopy.
Main Results:
- Successful percutaneous placement of 23-gauge needles with 250-micron fiberoptic cables through the cricothyroid membrane.
- Accurate submucosal needle maneuvering into Reinke's space, vocal fold, and thyroarytenoid gap.
- Demonstrated successful simulation of injection laryngoplasty.
Conclusions:
- Small caliber fiberoptic cables serve as effective transilluminating obturators for precise needle positioning in laryngeal tissue.
- This technique promises to improve accuracy in percutaneous laryngeal needle localization and instrumentation.
