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Three-dimensional direct laryngoscopy and bronchoscopy: enhanced visualization of the airway

Brian K Reilly, Michael A Holliday, Alex N Rock, Xin Kang, Raj Shekhar, Diego A Preciado
JAMA Otolaryngology—Head & Neck Surgery 2013, 139 (4): 367-70

IMPORTANCE: This is the first description of 3-dimensional (3D) pediatric airway endoscopy in the otolaryngology literature detailing the superior visualization with this technology. Ultimately, enhanced optics may further improve the treatment of airway pathology.

OBJECTIVE: To report the first case series examining the use of 3D direct laryngoscopy and bronchoscopy (DLB) in the diagnosis and management of laryngotracheal pathology.

DESIGN: Case series.

SETTING: Tertiary care pediatric hospital.

PARTICIPANTS: Three patients underwent both telescopic 2-dimensional (2D) and 3D DLB for comparison purposes: a 12-year-old boy for visualization of complete tracheal rings, a 23-year-old man for dilation of tracheal stenosis, and a 4-month-old boy for resection of subglottic cysts.

MAIN OUTCOME MEASURES: Enhanced visualization of laryngotracheal pathology and facilitated endoscopic surgery.

RESULTS: To our knowledge, this is the first case series in the otolaryngology literature examining the use of 3D DLB for the resection of subglottic cysts, dilation of tracheal stenosis, and visualization of complete tracheal rings. We believe that the 3D view offers qualitatively improved depth perception, accuracy of balloon placement, and appraisal of subglottic cyst resection margins.

CONCLUSIONS AND RELEVANCE: This emerging technology has vast potential for improving endoscopy, surgical precision in airway interventions, tissue preservation, and methods of teaching. More research is needed in this area regarding the benefits and advantages of 3D compared with 2D endoscopy.

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