Instruments For Direct Laryngoscopy

Sources: 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.