A new curved rigid layngoscope to overcome the difficult laryngeal exposure (DLE) in endolaryngeal surgery.

Difficult laryngeal exposure during endolaryngeal surgery is not uncommon; it is more likely to require prolonged or multiple attempts and be associated with complications. To overcome this problem, we have developed a new curved rigid laryngoscope, and we describe here its clinical usefulness in patients with difficult laryngeal exposure. A new rigid laryngoscope with a curvature of 70 degrees was designed to fit the curvature from the base of tongue to the larynx without excessive internal pressure of larynx. A flexible fiberoptic device was used to visualize a laryngeal lesion through a monitoring system. We also developed forceps and a suction device with the same curvature to manipulate the lesion in the larynx. This new device provided excellent glottic visualization in seven patients with difficult laryngeal exposure. We accomplished surgery for laryngeal lesions and biopsy successfully without any complications. Postoperative morbidity was minimal. In conclusion, a new curved rigid laryngoscope with a fiberoptic imaging system may provide better laryngeal visualization and less traumatic manipulation in patients with difficult laryngeal exposure.