A Novel Laryngoscope With an Adjustable Distal Tip.

OBJECTIVES: Various laryngoscopes are currently available for supraglottic, glottic, and cervical esophageal exposure, yet none allow for adjustable articulation of the laryngoscope distal tip. We sought to create a new laryngoscope to improve anatomic field of view exposure. STUDY DESIGN: Novel laryngoscope device validation study. MATERIALS AND METHODS: Three-dimensional printed plastic and titanium prototype designs were created using Solidworks. Validation testing was performed in a cadaveric model. Optimal exposure of the cadaveric larynx and supraglottis was determined by ensuring the endoscope tip was exactly 2.5 cm from the level of the vocal cords. The prototype exposure (22-cm adjustable tip laryngoscope) was compared to the Weerda (18-cm distending laryngoscope) and Dedo (18-cm operating laryngoscope) laryngoscope exposures. Anteroposterior (AP) and lateral (L) exposure measurements were obtained from analysis of endoscopic images. Objective millimeter quantification was performed by pixel calibration to the known width of the vocal cord. RESULTS: The prototype provided 77.3-mm AP and 40.6-mm L exposure of the cadaveric larynx and supraglottis. These measurements were then compared to the exposure provided by the Weerda (49.9-mm AP, 40.4-mm L) and Dedo (15.7-mm AP, 18.6-mm L) laryngoscopes. The investigators found the prototype had similar handling characteristics to the Weerda laryngoscope and laryngeal instrumentation was enhanced due to a wider field of view. CONCLUSION: This novel laryngoscope with an adjustable distal tip provides improved exposure of the supraglottis and glottis in a cadaveric study and has the potential to be used for both supraglottic/glottic and proximal esophageal procedures. LEVEL OF EVIDENCE: 5 Laryngoscope, 2020.