[Comparative analysis of the efficacy of two rigid laryngoscopy approaches in exposing laryngeal structures]

Objective:To compare the differences between the linear and oblique approaches in rigid laryngoscopy regarding the exposure of key laryngeal structures and patient tolerance. Methods:A total of 104 patients admitted to He'nan Provincial People's Hospital from January to October 2025 were randomly assigned to the straight approach group （n=51） or the oblique approach group （n=53） using a random number table. All patients underwent examination by the same operator using a 70° rigid laryngoscope. Evaluators, blinded to the group allocation, scored the exposure of various laryngeal anatomical structures （including the anterior commissure, ventricular bands, and laryngeal ventricles）, and the total scores were calculated. Procedural difficulty and adverse events were also recorded. Results:No significant differences were observed between the two groups in baseline characteristics such as age, gender, and Friedman classification（P>0.05）. There were no statistically significant differences in the total laryngeal exposure score or the procedural difficulty rating between the two groups（P>0.05）. However, for specific anatomical sites, the oblique approach group demonstrated significantly higher exposure scores for the anterior commissure（1.61±0.70 vs. 1.87±0.49, P<0.05） and the right ventricular band（1.61±0.67 vs. 1.90±0.36, P<0.05） compared to the straight approach group. Conversely, the exposure score for the left laryngeal ventricle was lower in the oblique approach group than in the straight approach group（1.76±0.62 vs. 1.38±0.63, P<0.05）. No significant differences were observed in adverse events occurred in either group. Conclusion:Both the linear and oblique approaches overall exposure efficacy are comparable, they exhibit complementary advantages for specific anatomical structures: the oblique approach provides better visualization of the anterior commissure and right ventricular band, whereas the straight approach offers superior exposure of the left laryngeal ventricle and better assessment of vocal cord mobility symmetry.