Accepted for presentation at the 132nd Annual Meeting of the American Laryngological Association, Chicago, Illinois, April, 2011.
How I Do It
Article first published online: 12 OCT 2011
Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 121, Issue 11, pages 2396–2398, November 2011
How to Cite
Verma, S. P. and Dailey, S. H. (2011), Overcoming nasal discomfort—A novel method for office-based laser surgery. The Laryngoscope, 121: 2396–2398. doi: 10.1002/lary.21911
The authors have no financial disclosures for this article.
The authors have no conflicts of interest to disclose.
- Issue published online: 21 OCT 2011
- Article first published online: 12 OCT 2011
- Manuscript Accepted: 3 MAY 2011
- Manuscript Received: 28 MAR 2011
- laryngeal surgery;
- laser laryngeal surgery;
- transoral laser
The passage of a flexible channeled laryngoscope for office-based laser laryngeal surgery can be limited by narrow nasal passages, nasal discomfort, or both. We describe a novel method for delivering the laser fiber transorally with simultaneous laryngeal visualization to avoid these limitations. This technique can be employed with instruments available in most otolaryngologists' offices.
A retrospective chart review was performed and procedural details were recorded.
Technical description: A laser fiber was threaded through the shaft of an Abraham cannula. A patient was seated in an otolaryngology examination chair and instructed to hold and stabilize his own tongue. Using his nondominant hand, the surgeon placed a rigid angled telescope into the patient's oral cavity for laryngeal visualization. Using his dominant hand, the surgeon simultaneously introduced the laser fiber threaded through the Abraham cannula into the patients oral cavity and guided it towards the patients larynx. Energy from the PDL, KTP, or CO2 flexible laser fibers was then delivered for management of glottic papillomatosis and leukoplakia. Treatment of glottic lesions was achieved successfully in all cases with titration endpoints identical to the transnasal approach.
For patients who cannot tolerate transnasal passage of a flexible channeled laryngoscope during office-based laser laryngeal surgery, an attractive alternative to surgery under general anesthesia is the transoral technique. This approach does not rely on distal chip endoscopes and can be performed with existing equipment in an office setting.