Tamura Koichi, Kim Masanobu, Abe Koji, Toda Naoki, Jinouchi Osamu, Kalubi Bukasa, Takeda Noriaki
Department of Otolaryngology, University of Tokushima School of Medicine, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
Auris Nasus Larynx. 2009 Dec;36(6):677-81. doi: 10.1016/j.anl.2009.04.006. Epub 2009 Jul 23.
We developed a new video laryngo-pharyngoscope with a shape-holding coiled tube and examined its effectiveness in some patients.
The video laryngo-pharyngoscope is designed to inspect the pharynx and larynx transorally and to perform surgical manipulations. The scope consists of a coiled tube, a grip with trigger connected to the forceps and a CCD Camera with a battery. The stainless coiled tube of the scope is flexible but shape-holding, so that its shape can be changed by hand with the characteristic that the new orientation remains invariable during both inspection and operation in the pharynx and larynx. After a local anesthesia, the operator holds the scope in one hand and pulls the patient's tongue by the other hand. The operator then inserted the scope transorally while monitoring video images that were wirelessly transferred to the display to ensure that the forceps has reached the area of interest and treated lesions successfully.
Using the scope, we successfully examined the upper airway lesions and removed foreign bodies from the pharynx and performed both resection of a benign tumor and taking a biopsy of a malignant tumor from the pharynx and larynx. But, we could hardly remove vocal fold polyps because of the structural limitation of the scope.
We demonstrated that the new video laryngo-pharyngoscope can be used safely and successfully in the inspection and removal of lesions in the oropharynx and supraglottic area of the larynx and will be a useful tool for minimally invasive office-based surgery.
我们研发了一种带有可保持形状的盘管的新型视频咽喉镜,并在部分患者中检验了其有效性。
该视频咽喉镜旨在经口检查咽喉并进行手术操作。它由一根盘管、一个带有与钳子相连扳机的手柄以及一个带电池的CCD摄像头组成。该咽喉镜的不锈钢盘管具有柔韧性但能保持形状,因此可以手动改变其形状,且在咽喉检查和手术过程中,新的形状能保持不变。局部麻醉后,操作者一手握住咽喉镜,另一手牵拉患者舌头。然后,操作者经口插入咽喉镜,同时监测无线传输至显示屏的视频图像,以确保钳子到达感兴趣区域并成功治疗病变。
使用该咽喉镜,我们成功检查了上气道病变,从咽部取出了异物,并对咽喉部的良性肿瘤进行了切除以及对恶性肿瘤进行了活检。但是,由于该咽喉镜的结构限制,我们很难切除声带息肉。
我们证明了这种新型视频咽喉镜可安全、成功地用于口咽和喉声门上区病变的检查与切除,将成为基于门诊的微创外科手术的有用工具。