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Medical ArticlesResume Of Tracheotomy
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Instruments For Direct Laryngoscopy
Category: DIRECT LARYNGOSCOPY
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
In undertaking direct
laryngoscopy one must always be prepared for bronchoscopy,
esophagoscopy, and tracheotomy, as well. Preparations for bronchoscopy
are necessary because the pathological condition may not be found in
the larynx, and further search of the trachea or bronchi may be
required. A foreign body in the larynx may be aspirated to a deeper
location and could only be followed with the bronchoscope. Sudden
respiratory arrest might occur, from pathology or foreign body,
necessitating the inserting of the bronchoscope for breathing
purposes, and the insufflation of oxygen and amyl nitrite. Trachectomy
might be required for dyspnea or other reasons. It might be necessary
to explore the esophagus for conditions associated with laryngeal
lesions, as for instance a foreign body in the esophagus causing
dyspnea by pressure. In short, when planning for direct laryngoscopy,
bronchoscopy, or esophagoscopy, prepare for all three, and for
tracheotomy. A properly done direct laryngoscopy would never
precipitate a tracheotomy in an unanesthetized patient; but direct
laryngoscopy has to deal so frequently with laryngeal stenosis, that
routine preparation for tracheotomy a hundred unnecessary times is
fully compensated for by the certainty of preparedness when the rare
but urgent occasion arises.
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