Class zero airway and laryngoscopy.
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This paper describes a clinical situation where it was impossible to obtain a biopsy of a lesion at the anterior commissure in a patient with progressive hoarseness of voice using standard microlaryngoscopy techniques. Due to anatomical difficulties and a histological suggestion of laryngeal papillomatosis the incisor teeth were deliberately removed to allow an adequate view of the larynx and to facilitate further access.
In phonosurgery, in cases where it is not possible to use a rigid laryngoscope, a flexible fibrescope with laryngeal-mask ventilation may be used. In flexible fibreoptic surgery, the forceps are normally inserted through a small channel in the fibrescope. Since only a small forceps tip can pass through this channel, a limited range of forceps has been available for use in fibrescope procedures. We have developed a new type of forceps for flexible fibre-optic surgery that allows this size limitation to be overcome. The new forceps is made up of two parts: (i) the forceps tip and its control wire assembly, and (ii) a detachable handle. A wide range of forceps can be used, including those with tips larger than the biopsy channel. We report a case that was treated with this new technique.
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