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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2006 February;165(1):47-9
An open approach for laryngeal surgery without suspension
Dedivitis R. A., Guimarães A. V.
Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine Metropolitan University of Santos, Santos, Brazil
Microscopic and telescopic surgery represent the state of the art in endoscopic laryngeal surgery but drawbacks are possible during its application. Suspension microlaryngeal surgery may not be possible in cases where the surgeon is not able to look along a straight line from the upper teeth to the epiglottis due to anatomical difficulties. The standard technique laryngoscopy can be sometimes impossible. We present the case of a thirty-nine-year-old Caucasian man with a large polyp in the left vocal fold. Rapid-sequence intubation using conventional laryngoscopic technique was not possible at the initial approach. Fiberoptic bronchoscopy was performed one week later in order to achieve the nasotracheal intubation but the suspension laryngoscopy was not possible. A cervical incision was performed over the cricothyroid membrane. A rigid 0 contact telescope was introduced through this incision and the microscissors and microtweezers allowed the complete remotion of the polyp from the subglottis region. The control examination showed no recurrence nor residual lesion. This technique may help in larynx surgery in sellected patients who can not undergo the common suspension endoscopic laryngeal approach due to anatomical difficulties.