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Endotracheal Intubation in Mice via Direct Laryngoscopy Using an Otoscope
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Optimal Position for Transnasal Flexible Laryngoscopy.

Hamdi Tasli1, Hakan Birkent2, Omer Karakoc3

  • 1Birecik State Hospital, Department of Otolaryngology, Head and Neck Surgery, Sanliurfa, Turkey.

Journal of Voice : Official Journal of the Voice Foundation
|December 25, 2018
PubMed
Summary

Simple head extension and sniffing position provide the best laryngeal view during transnasal flexible laryngoscopy (TFL). These positions offer superior glottic visualization compared to the neutral position for improved diagnostic accuracy.

Keywords:
EndoscopyNeutral positionSimple head extensionSniffingTransnasal flexible laryngoscopy

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Area of Science:

  • Otolaryngology
  • Medical Imaging

Background:

  • Transnasal flexible laryngoscopy (TFL) is a common diagnostic procedure.
  • Optimal patient head and neck positioning for TFL requires further investigation.

Purpose of the Study:

  • To determine the most effective head and neck position for optimal laryngeal visualization during TFL.
  • To compare the efficacy of simple head extension (SHE), sniffing position (SP), and neutral position (NP).

Main Methods:

  • 132 patients undergoing TFL were randomized into three head position groups: SHE, SP, and NP.
  • Videos were evaluated by three blinded laryngology experts using a grading system.
  • Inter-observer agreement was assessed using the kappa statistic.

Main Results:

  • SHE and SP yielded significantly better laryngeal views (Grade 1: 96.2% and 95.5%, respectively) compared to NP (Grade 1: 3.8%).
  • NP resulted in lower quality views (Grade 2a: 62.9%, Grade 2b: 28%, Grade 3: 5.3%).
  • High inter-observer agreement (kappa scores >0.8) indicated reliable results.

Conclusions:

  • Both SHE and SP are superior to NP for achieving optimal glottic view in TFL.
  • These findings support the use of SHE or SP for routine TFL procedures.