Author(s)
Tetsuji Sanuki, MD PhD
Naoki Takamoto, MD
Shogo Sumiya, MD
Affiliation(s)
Nagoya City University Graduate School of Medical Sciences;
Abstract:
Introduction: Laryngoplasty requires manipulation of the vocal folds, which are not visible during the operation, and the technique's widespread use is limited by the need for adequate knowledge of local anatomy, the small surgical field, and the high level of skill required for the procedure under local anesthesia. Although it is possible to train surgeons to use a microscope or an endoscope, as in otological and nasal surgeries, this has not been done in the case of laryngoplasty as the position of the trunk, neck, and head cannot be changed freely, and the patient's position is unnatural. In recent years, an exoscope has been developed that can provide a stereoscopic view similar to that of a microscope, while using the same compact tool as an endoscope. The study aims to assess whether the 3D exoscopic surgical technique can be applied in laryngoplasty, and to explore the possibility of it ultimately replacing this macro surgery in the future.
Methods: This is a retrospective study in which 58 patients affected by voice disorders, who underwent surgery either using the 3D exoscope (28) or without this device (macro surgery; 30) were included. The feasibility of all the surgical steps solely using the 3D exoscope was evaluated. The exoscope group and macro group were compared taking into account the following factors: time of the surgery and vocal function outcomes, as well as intraoperative and postoperative complications.
Results: No intraoperative or postoperative complications occurred in any of the procedures. The average operative time was 144 minutes in the exoscope group and 147 minutes in the macro group. No significant statistical differences were identified between the two groups (p > 0.05). The vocal function outcomes were fully comparable.
Conclusions: While this study represents an initial experience, our results indicate that the exclusive use of the 3D exoscope is feasible for all open approaches. The use of the 3D exoscopic technique shows promise for future laryngoplasty.