Direct laryngoscope check the throat need to use a direct laryngoscope to the tongue and epiglotta directly provoke, does not belong to the throat of the routine examination method, because the examination is a invasive examination of the throat examination method, the patient in the mucosa In the case of topical anesthesia, it is generally difficult to tolerate, usually requiring hospitalization under general anesthesia conditions. Direct laryngoscopy can learn more about the abnormal throat structure, clear the location and extent of lesions, if necessary, the biopsy of diseased tissue. Direct laryngoscopy can not obtain functional indicators of the larynx. Since the development of fiber laryngoscopy and electronic laryngoscopy, direct laryngoscopy as a means of inspection of its application is getting smaller and smaller, but as a surgical means of operation is widely used in clinical.
Direct laryngoscopy according to their use may have a variety of types, such as flake laryngoscopy (flaky straight, curved two, generally used for anesthesia), ordinary direct laryngoscopy, lateral laryngoscope laryngoscope, , Support laryngoscopy and suspended laryngoscope. According to their size and baby, children and adult laryngoscopy points. If additional special equipment, such as microscopes, laser systems, endoscopic systems, cameras and camera systems, easier to check, surgical treatment and teaching.
1. indirect laryngeal examination and fiber laryngoscopy failed, or indirect laryngoscopy and fiber laryngoscopy vision is not satisfied with the feasibility of direct laryngoscopy.
2. Take the laryngeal tissue biopsy specimens, or directly wipe the throat secretions to do the examination.
3. Treatment of laryngeal lesions, such as benign tumor resection (such as vocal cord polyps, small laryngeal benign tumor resection). Laryngeal scar stenosis dilatation, electrocautery, local medication and remove the throat, trachea, esophageal foreign body and other operations at the top.
4. Tracheal anesthesia or bronchoscopy is not easy to follow the tube can be assisted by direct laryngoscopy.
5. For endotracheal intubation, for anesthesia intubation and rescue of laryngeal obstruction patients.
6. Pediatric bronchial examination, you can first split the laryngeal laryngoscope exposed glottis, and then into the bronchoscope.
Cervical lesions, such as dislocation, tuberculosis, trauma, etc., are not suitable for the implementation of this surgery. Serious illness, severe debilitation and late pregnancy, although not absolute contraindications, but should be very cautious.
Inspection method (except laryngoscope and suspended laryngoscope)
Mucosal surface anesthesia under the direct laryngoscopy method, the surgeon left hand mirror, put a thick layer of gauze block to protect the above teeth to the right hand to push the upper lip, so as not to be mirror pressure on the teeth injured, and then the mirror along the tongue Back into the mouth, the transfer to the center line in depth to the tongue, from the laryngoscope to see the epiglottis, the right hand thumb and the index finger from the front and rear to help grip the mirror tube. So that the laryngoscope near the end of the tilt (sitting forward tilt), distal point to the pharyngeal wall, but not with the contact. Continue to enter the mirror more than epiglottis away from the edge, see the tired after the nodules, the left hand to lift the power of the upward laryngoscope, pressurized in the epiglottic, so that it completely lifted, you can expose the larynx. At this point, such as the occurrence of laryngeal spasm and acoustic splitting closed, can not glimpse the cleft cleft, the laryngoscope should be fixed in situ, wait for a moment to wait for laryngeal spasm contact can see the image of the throat. Such as laryngoscopy too deep, touch the laryngeal mucosa caused by reflex spasm, should be withdrawn a little laryngoscopy, laryngeal spasm after the release, and then observed, the subjects were issued "clothing" sound, observe the vocal cord movement, Use the right hand to do all the necessary operations.
If the subject is short and thick neck, the front of the vocal cord is not easy to expose, the need to raise the head, left hand lift up the laryngoscope, right thumb from the laryngoscope to the next force, the right hand the other fingers to hold the right side of the patient Above the teeth, the cohesive force together to lift tired. If this method is not successful, please help the thyroid cartilage oppression or switch to the former joint laryngoscopy. The front joint laryngoscope can not only clearly see the vocal cords before the joint, and can be inserted into the acoustic cleft, check the glottis chamber. Check the young children, in order to prevent this postoperative laryngeal edema, laryngoscope tip can not oppressive epiglottis, only the tongue forward, epiglottous erect, you can expose the larynx.
Usually rarely occurs. In children, especially those who have spasm quality, surgery can occur serious, and even life-threatening laryngeal spasm. Operation, the action as gentle as possible to reduce the pharynx, laryngeal mucosal injury, reduce the occurrence of hematoma, bleeding or secondary infection probability.
Hangzhou Kangji Medical Instrument Co., Ltd
Address:No. 1668 Chunjiang East Road, Economic Development Zone Tonglu, Hangzhou, Zhejiang 311501, China
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