Dr.K.O.Paulose FRCS, DLO.Consultant ENT Surgeon.
Jubilee Hospital, Trivandrum, Kerala, South India
Microlaryngoscopy is a procedure in which the larynx is visualized through a microscope. It thus allows a magnified view of the larynx which is not possible on direct or indirect laryngoscopy.
The indications:
and To have a microscopic visualization of the larynx in cases of hoarseness of voice which cannot be diagnosed by indirect or direct laryngoscopy .
and Biopsy of laryngeal lesions.
and For assessment of laryngeal trauma.
and Excision of vocal nodules, cysts and haemangiomas
and Removal of foreign bodies
and Injection of teflon paste in the vocal cords in cases of vocal cord palsy
and Laser cordectomy in carcinoma of vocal cord
and Dilatation of subglottic stenosis
and Insertion of laryngeal stent
and Arytenoidectomy in cases of abductor cord palsy
Technique:
and Patient is under general anaesthesia
and The patient is in Boyce position with flexion of the cervical spine and extension of the atlanto-occipital joint
and A smaller size than normal endotracheal tube is used
and The laryngoscope is held in the right hand and inserted into the oral cavity till the epiglottis is visualized. The tip of the epiglottis is lifted with the laryngoscope. The larynx is then visualized and the scope is fixed to the chest piece
and An operative binocular microscope with 400 mm lens helps in examination of the larynx under microscope
Advantages:
and Magnified binocular vision
and Both hands of the operating surgeon are free for carrying out the procedure
and Exact precision is achieved when performing laser or cryosurgery
and Video attachment to the microscope allows documentation and teaching
For More Details:Please Read Microlaryngoscopy