Surgical Direct Laryngoscopy: Surgeon Preferences and Future Directions

Modern laryngoscopy has evolved since its innception in the mid-1800s. Many variations on the original direct laryngoscope have been developed, but surgeon practice patterns and preferences still need to be investigated. This study evaluates surgeon preferences for direct laryngoscopy and suspension apparatus for glottic, subglottic, and hypopharyngeal surgery. Secondary aims include understanding the rationale behind preferences and eliciting recommendations for future changes.

Survey.

An anonymous electronic survey was distributed to global laryngologists. Respondents were asked to report their laryngoscope preference(s), reason for their choice, and ideas for future innovation. Data were collected and aggregated.

In total, 128 laryngeal surgeons responded. Eighty-one (64%) identified as male. 106 (84%) completed a fellowship in laryngology. Most respondents (116, 90%) do not consider patient sex in primary laryngoscope selection. For glottic surgery, 51 (45%) used an adult Dedo, and 18 (16%) used the Universal Modular Glottiscope (UMG) system. "Size of working space" was the most cited reason for this selection (n = 62, 54%). In total, 45 (40%) selected an Ossoff-Pilling as the backup laryngoscope in cases of inadequate exposure for glottic surgery, with 67 (60%) citing "favorable design for difficult exposures" as the reason. For hypopharyngeal surgery, 72 (56%) used a Weerda, and 48 (38%) used a Benjamin/Dohlman diverticuloscope. For subglottic surgery, 54 (42%) used an adult Dedo, 21 (17%) selected a Garrett-Ossoff-Pilling, and 34 (26%) chose "other" (most commonly UMG and Ossoff-Pilling). Most popular laryngoscope modification suggestions included altering the laryngoscope shape and adding a port.

Laryngologists surveyed had variable agreement among survey responses, and the respondents proposed potential modifications and future directions for laryngoscopy, all of which warrant further work in this area.