The Journal of otolaryngology
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Comparative Study
Laryngeal examination: a comparison of mirror examination with a rigid lens system.
Indirect mirror laryngoscopy is the standard screening examination used in patients with complaints referable to the larynx and upper aerodigestive tract. The purpose of this study was to prospectively evaluate, in 100 patients, the diagnostic accuracy and examination success rate of indirect laryngoscopy versus a rigid rod examination. Fifty-two percent of mirror examinations were successful as were 83% of rod exams. ⋯ From the 29 patients who underwent direct laryngoscopy, one false negative and one false positive mirror examination and one false positive rod examination were found. We conclude that the mirror is a useful screening tool so long as strict examination criteria are used. The rigid rod adds further diagnostic information in those patients who cannot be evaluated with a mirror.
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A novel approach to tracheostomy has recently been introduced, based on the Seldinger guide-wire technique. A well-packaged percutaneous tracheostomy kit promises a rapid and safe alternative to the traditional surgical tracheostomy. ⋯ Deficiencies in the kit instruments were discovered which, with the expected "learning curve," led to unexpected difficulties. Thus, the promise of percutaneous tracheostomy remains as yet unfulfilled.