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困难喉镜检查病例中喉显微手术技术的变体

Variant of the Technique for Laryngeal Microsurgery in Cases of Difficult Laryngoscopy.

作者信息

Setton Antonio Roberto Ferreira, D'avila Jeferson Sampaio, Gurgel Ricardo Queiróz, Tsuji Domingos Hiroshi, D'avila Daniel Vasconcelos, Góis Carlos Rodolfo Tavares de, Meurer Ana Taise de Oliveira, Gurgel Helaina Peixoto

机构信息

Department of Otorhinolaryngology, Faculty of Medicine, Universidade Federal de Sergipe, Aracaju, SE, Brazil.

Department of Pediatrics, Universidade Federal de Sergipe, Aracaju, SE, Brazil.

出版信息

Int Arch Otorhinolaryngol. 2019 Jan;23(1):18-24. doi: 10.1055/s-0038-1660825. Epub 2018 Aug 9.

DOI:10.1055/s-0038-1660825
PMID:30647779
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6331303/
Abstract

Low exposure of the larynx can make laryngeal microsurgery difficult or even impossible. The application of rigid and contact endoscopy enabled oblique and retrograde angled visualization, allowing transoperative staging with greater reach of the anatomical areas. However, there is difficulty or even impossibility of performing the surgical act, due to the incompatibility of the angled path with the straight surgical tools.  To demonstrate the efficiency of the variant of the technique for laryngeal microsurgery in cases of difficult laryngoscopy and to analyze the new surgical instruments specific to the endoscopic procedure.  This is a cross-sectional retrospective study, based on the analysis of 30 medical records of patients treated surgically at a philanthropic hospital in the state of Sergipe, Brazil, between the years of 2014 and 2015.  The technical variant used 30- and 70-degree endoscopes that provided complete oblique view of the endolarynx. The association of angled instruments (forceps, suction pumps, retractors and scissors) enabled the execution of the surgical procedures.  The association of rigid endoscopy with angled instruments promoted full visualization of the surgical lesion and operative resolution.

摘要

喉部暴露不足会使喉显微手术变得困难甚至无法进行。硬质接触式内镜的应用实现了倾斜和逆行角度的可视化,使得术中能够对解剖区域进行更广泛的分期。然而,由于角度路径与直形手术器械不兼容,手术操作存在困难甚至无法进行。

为了证明该喉显微手术技术变体在喉镜检查困难病例中的有效性,并分析该内镜手术特有的新型手术器械。

这是一项横断面回顾性研究,基于对2014年至2015年间在巴西塞尔希培州一家慈善医院接受手术治疗的30例患者的病历分析。

该技术变体使用了30度和70度的内镜,可提供喉内的完整斜视图。角度器械(镊子、吸引泵、牵开器和剪刀)的联合使用使得手术操作得以执行。

硬质内镜与角度器械的联合使用促进了手术病变的全面可视化和手术解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/0e338394ce92/10-1055-s-0038-1660825-i0779or-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/4e56437e4fb6/10-1055-s-0038-1660825-i0779or-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/a457fc2ef405/10-1055-s-0038-1660825-i0779or-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/b3b11ca99713/10-1055-s-0038-1660825-i0779or-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/0d92f9802c15/10-1055-s-0038-1660825-i0779or-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/6adf9311e23c/10-1055-s-0038-1660825-i0779or-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/0e338394ce92/10-1055-s-0038-1660825-i0779or-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/4e56437e4fb6/10-1055-s-0038-1660825-i0779or-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/a457fc2ef405/10-1055-s-0038-1660825-i0779or-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/b3b11ca99713/10-1055-s-0038-1660825-i0779or-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/0d92f9802c15/10-1055-s-0038-1660825-i0779or-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/6adf9311e23c/10-1055-s-0038-1660825-i0779or-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cbe/6331303/0e338394ce92/10-1055-s-0038-1660825-i0779or-6.jpg

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Management of difficult suspension laryngoscopy using a GlideScope® Video Laryngoscope.使用GlideScope®视频喉镜管理困难的悬吊喉镜检查
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Curved rigid laryngoscope: missing link between direct suspension laryngoscopy and indirect techniques?弯曲硬质喉镜:直接悬吊喉镜检查与间接技术之间缺失的环节?
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