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"Hanger" in Intubation and Laryngoscopy
Devkumar Rengaraja1, Mohan Jagade1, Radhika Sonate1
1Grant Medical College and Sir JJ Group of Hospitals, Room No 216, 300 Resident Hostel, Byculla, Mumbai, Maharashtra 400008 India.
Summary
A new cricoid catapult device significantly improves laryngeal exposure during laryngoscopy. This innovation aids surgeons in visualizing glottic lesions, particularly anterior commissure tumors, leading to better surgical outcomes.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Medical Device Development
Background:
- Adequate laryngeal exposure during laryngoscopy is challenging, especially for anterior commissure lesions.
- Existing maneuvers often fail to provide sufficient visualization, impacting surgical outcomes.
- Difficulty in exposure is common in patients with anteriorly placed larynges, short necks, or obesity.
Purpose of the Study:
- To develop and evaluate a novel device, the cricoid catapult, for improved laryngeal exposure.
- To assess the device's ability to deliver uniform pressure over laryngeal cartilage.
- To determine if the device enhances visualization of glottic lesions, particularly at the anterior commissure.
Main Methods:
- A prospective study involving 44 patients, divided into two groups (22 each).
- Group A received standard digital cricoid pressure.
- Group B utilized the cricoid catapult device for cricoid pressure.
- Exposure distance at the anterior commissure level was measured and compared between groups.
Main Results:
- The cricoid catapult group (Group B) demonstrated a significantly greater mean exposure distance (11.76) compared to the digital cricoid pressure group (Group A) (9.09).
- Statistical analysis using the Anova Test showed a highly significant difference between the groups (p < 0.0001).
- The cricoid catapult proved effective in providing uniform pressure over the laryngeal cartilage.
Conclusions:
- The cricoid catapult is an economical and effective device for improving laryngeal exposure during laryngoscopy.
- It is particularly beneficial for difficult intubations in patients with challenging anatomy.
- The device facilitates adequate visualization of glottic lesions, especially anterior commissure pathologies, leading to superior operative outcomes.