VIDEO LARYNGOSCOPE

 

VIDEO LARYNGOSCOPE

What does Larynx do?

The larynx is a hollow tube that connects the rest of the respiratory system to the throat (pharynx).

It is also called as voice box since it helps in swallowing and protects the vocal cords. The major

role of larynx is assisting you in speaking, breathing, and swallowing. Larynx is located at the rear

of your throat and the top of your trachea, or windpipe. It is home to your vocal cords, which

vibrate to produce sounds when you talk.

Overview of laryngoscope:

Laryngoscope is an endoscope of the larynx. A laryngoscope is a small hand instrument that

doctors use to see into your larynx and other neighboring regions of your throat, or to introduce a

tube into your windpipe to help you breathe. A small video camera is frequently included in

modern versions of the laryngoscope gadget.

• Indications for laryngoscopy

 Diagnostic

 Therapeutic

Diagnostic:

1. Hoarseness

2. Voice changes

3. Chronic cough

4. Choking episodes

5. Odynophagia / Dysphagia

6. Chronic throat pain

7. Globus sensation

8. Hemoptysis

9. Referred otalgia

10. Dyspnea

11. Shortness of breath

12. Dysarthria

13. Stridor

14. Suspension of laryngeal foreign body

15. Suspension of carcinoma

Therapeutic:

1. Intubation

2. Foreign body removal

3. Biopsy

4. Micro-laryngeal surgery

5. Placing gastric tube, Transesophageal echocardic probe

Video Laryngoscope:

Video laryngoscopy is a type of indirect laryngoscopy in which the doctor does not look at the

larynx directly. Instead, a fiberoptic or digital laryngoscope (a camera with a light source) is

inserted trans nasally (through the nose) or trans orally (through the mouth) to see the larynx

(through the mouth).

During video laryngoscopy, images and recordings taken during the process can be seen on a

monitor by physicians, patients, and others. It can also be recorded and watched at a later date. The

photos and video can also be used to track the evolution of the disease and its treatment. When the

pictures are presented on the monitor, they are enlarged, which aids in a thorough study of the

larynx. Fiberoptic intubation is based on video laryngoscopy.

Technique

Video laryngoscopy is a relatively recent technology that was developed to improve tracheal

intubation success rates. A high-resolution micro camera fitted on the tip of a curved blade and

coupled to a small portable digital monitor improves the view of the vocal cords and, as a result,

the direct laryngoscopy success rate. The larynx is visualized from outside the mouth orifice during

direct laryngoscopy. The distance between the laryngoscopist's eye and the vocal cords is

considerable (30–40 cm). With a traditional laryngoscope, this decreases the angle of view to about

15°. Direct viewing of the airway might be difficult or impossible due to improper alignment of

the oral, pharyngeal, and laryngeal axes, as well as a variety of anatomic or pathologic reasons.

Since the digital camera, video laryngoscopy has substantially increased the angle of vision.

Because the digital camera and light source are put so close to the larynx (2–3 cm), video

laryngoscopy considerably increases the angle of vision.

Video laryngoscopy in the pre-hospital setting

Due to severe facial trauma, neck or cervical spine injuries, or oropharyngeal edema attributable

to angioedema or anaphylaxis, emergency care providers may be faced with a quickly deteriorating

airway status. Pre-hospital patients typically have simultaneous head injuries, multi-system

trauma, or suspected cervical spine injuries, and EMS providers are frequently involved in

maintaining the most challenging airways.

As a result, the safest and most efficient approach with the lowest morbidity rate should be used

to secure a definitive airway. As a result, VL could be an excellent option for safer laryngoscopy

and intubation.

Advantages of using video laryngoscope

• Because the eye and airway do not have to be aligned up as in direct laryngoscopy,

laryngeal visibility is improved.

• When compared to direct laryngoscopy, less force is used.

• Less cervical spine movement.

• Short learning curve.

• Laryngoscopy and intubation may cause less hemodynamic stress.

• Useful teaching tools.

• When compared to flexible fiber optic laryngoscopes, portability and cost are improved.

• Higher success rate in general, especially in tough conditions.