Thursday, December 15, 2016

Direct Laryngoscope

As the name suggests, this instrument is used for direct visualization of larynx and hypopharynx. 




There are two sets of indications for direct laryngoscopy: Diagnostic and Therapeutic.

Diagnostic:
             1. In infants and young children when indirect laryngoscopy is not possible.
             2. In cases of unsuccessful indirect operations, ex. due to excess gag reflex.
             3. To examine hidden areas of larynx and hypopharynx.
             4. To take biopsy of abnormally growing tissue.

Therapeutic:
             1. Removal of benign lesions of larynx, ex. papilloma, fibroma.
             2. Removal of foreign bodies
             3. Dilatation of strictures of larynx.

Position of the head of patient during the procedure is to be taken care of. The head is elevated by 10- 15 cm by placing a pillow under the occiput. Neck is flexed on thorax and head extended on atlanto- occipital joint. (sniffing position or barking- dog position) 

IMPORTANT: Laryngoscope is lubricated prior to the introduction into larynx and hypopharynx, with liquid paraffin or jelly. It is held by the handle (at the right side of the picture above) in the left hand while right hand is used to retract the lips to prevent injury to the upper teeth.

Thats all
- Jaskunwar Singh

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