KOICHI OMORI,
MD; KAORU SHINOHARA, MD; TOMOKO TSUJI, MD
KOBE, JAPAN
HISAYOSHI KOJIMA, MD
KYOTO, JAPAN
This paper introduces videoendoscope-assisted laryngeal surgery with office-based
equipment. With this technique, a patient is seated and the nose, pharynx,
and larynx are topically anesthetized. A flexible videoendoscope with a
light-sensitive charge-coupled device chip built into the tip is transnasally
inserted by an assistant. Specially designed fine-tipped forceps and scalpels
were developed for removal of laryngeal lesions. Videoendoscopic laryngeal
surgery was undertaken in 114 cases of laryngeal lesions such as polyps,
granuloma, and cancer. For benign vocal fold lesions, postoperative vocal
function was shown to be improved on aerodynamic and perceptual analyses.
For laryngeal tumors, biopsy of the lesion was easily undertaken. Videoendoscopic
laryngeal surgery presents the following advantages. It is applicable to
outpatients not requiring general anesthesia, it enables functional monitoring
of the patient's voice and vocal fold during phonation, it allows for delicate
manipulations with both hands, and it gives high-resolution images in comparison
to conventional fiberseopy. |