Does the Angle of Rigid Endoscope Makes a Difference in Videolaryngoscopy

Authors describe the technique of office based rigid video laryngoscopy with 0° endoscope and compare with technique of 70° 4 mm videolaryngoscopy. (1) To compare and assess the efficacy of techniques of 0° and 70° office based video laryngoscopy for examining laryngopharyngeal disorders at Ear Nose Throat (ENT) Out Patient Department level. (2) To assess whether the degree of angle of the rigid endoscope makes any difference in the visualisation in videolaryngoscopy. Prospective non randomised double blinded study of direct videolaryngoscopies using 0° and 70° 4 mm rigid endoscope (Karl Storz, Germany) done at M.I.M.E.R. Medical College and Sushrut ENT Hospital, Talegaon-D, Pune, India, during the period of October 2016 to February 2017. Patients with predominant complaints of change of voice and foreign body sensation in throat were subjected for Videolaryngoscopy by 0° and 70° 4 mm Endoscope. 375 patients were examined with both the techniques. After the end of the procedure, the patient preference or discomfort with any of the techniques was enquired. The unlabelled endoscopic recording of both techniques was visualised by the second author to compare and evaluate the 0° videolaryngoscopy with 70° in terms of extent of visualisation. The time taken for each technique was recorded. The data of all patients has been analysed in terms of patient and surgeon grading. On statistical analysis, both the techniques with 0° as well as 70° rigid endoscope videolaryngoscopy were found to be comparable. Our study concludes that both the endoscopes are equally efficient in comparable laryngeal visualization. Hence, the degree of angulation of the rigid endoscope makes no difference in videolaryngoscopy. With little practice, 0° videolaryngoscopy may be extended for routine use in laryngological examination.