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Office Rigid Laryngoscopy as a Predictor for Glottic Exposure in Microlaryngoscopy.

M K Manjunath¹, Ravi Sachidananda², R Jyothi Swarup³

¹Sparsh Hospitals, Bengaluru, 560055 India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India

|April 3, 2024

Summary

Office-based rigid laryngoscopy effectively predicts glottic exposure for microlaryngeal surgery. This screening tool helps anticipate surgical conditions, improving planning for benign vocal cord lesion procedures.

Keywords:

Difficult laryngoscopy Laryngeal exposure Microlaryngoscopy

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Area of Science:

Otolaryngology
Surgical Planning
Diagnostic Imaging

Background:

Microlaryngeal surgery requires optimal glottic exposure, which is often difficult to predict preoperatively.
Predicting laryngeal exposure pre-surgery is crucial for successful microlaryngeal procedures.

Purpose of the Study:

To evaluate the utility of office-based rigid laryngoscopy (70°) as a screening tool.
To predict laryngeal exposure during subsequent micro laryngoscopy for benign vocal cord lesions.

Main Methods:

Sixty-nine patients with benign vocal cord lesions underwent office-based rigid laryngoscopy (70°).
Laryngoscopy was graded (1-3) based on glottic and anterior commissure visualization.
Grades were correlated with actual laryngeal exposure during micro laryngoscopy.

Main Results:

A strong correlation (Cramer's V = 0.746) was found between office-based grading and operative exposure.
Grade 1 predicted favorable exposure (93%); Grade 2 predicted favorable (66%) or partially favorable exposure (33%).
Grade 3 invariably resulted in unfavorable exposure, necessitating angled telelaryngoscopy.

Conclusions:

Office-based rigid laryngoscopy with a 70° telescope is a reliable predictor of glottic exposure during microlaryngeal surgery.
The ease of office examination correlates with the ease of operative microlaryngeal surgery, aiding surgical planning.