Transoral laryngeal surgery under flexible laryngovideostroboscopy

Although direct microlaryngoscopic surgery is universally accepted as the standard procedure for endolaryngeal surgery, general anesthesia and direct laryngoscopy are necessary during the procedure. Suspended laryngeal position also impedes intraoperative functional monitoring. Transoral laryngeal surgery under indirect laryngeal mirror or telescope has the advantage of sparing general anesthesia and direct laryngoscopy, but lower precision, difficult manipulation, and a high patient cooperation requirement make the procedure of limited application. Trying to overcome the above shortcomings, transoral laryngeal surgery under flexible laryngovideostroboscopy (FLVS) is undertaken at our institute. The surgery is performed at an outpatient office under topical anesthesia, with the help of high-resolution fiberoptic stroboscopy, high-quality CCD videocamera, and monitor. From October, 1993 to March, 1996, 157 patients with selected laryngeal problems were operated upon using this technique, and 150 patients smoothly completed the procedure with satisfactory results. The technique is highly effective, especially for limited-manipulation, lower precision procedures and for patients who are not candidates for general anesthesia. With proper patient selection, this is a cost-effective surgery of low invasiveness and high applicability.