• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.7-17
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• 2019

Purpose: The aim of this study was to verify the necessity of endotracheal intubation through video laryngoscope and to provide basic data to inform the provision of video laryngoscope education. Methods: Eighty paramedic students participated in this study. A survey was conducted from November 5, 2018 to December 7, 2018. Data were analyzed with independent t-tests, and the chi-squared test. Results: The video laryngoscope is a highly usable instrument that can easily be applied during training. The instrument provides better visual evaluation of the normal airway (p=.004), the airway in case of cervical collar and head fixation (p=.000), and the airway in case of tongue edema (p=.000). The time of endotracheal intubation in the normal airway was significantly less with the video laryngoscope compared with the direct laryngoscope. The success rate of tracheal intubation was significantly higher in the video laryngoscope group than in the direct laryngoscope. Conclusion: This study suggests the necessity of education on endotracheal intubation through video laryngoscope in the professional airway maintenance training course of emergency department students. The video laryngoscope is easier to apply than the direct laryngoscope in cases of intubation in various clinical situations.

• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.87-99
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• 2019

Purpose: The aim of this study was conducted to assess the proficiency of both direct laryngoscopy and video laryngoscopy and the usefulness of each laryngoscope, thereby provide basic data for further education using video laryngoscopy. Methods: Forty one paramedic subjects participated in this study. Usability was measured with the System usability scale. The Macintosh direct laryngoscope and $C-MAC^{(R)}$ video laryngoscope were two instruments evaluated in the study. Results: Training with video laryngoscopy showed significantly better results within the categories of dental injury (p=.004), esophageal intubation (p=.001), and proper depth placement of intubation tubes (p=.019). The results of the System usability scale questionnaire and the degrees of visibility based on the Cormack & Lehane classification were also found to be better achieved with the video laryngoscopy (p=.000). Conclusion: This study suggests enhancing education with video laryngoscopy, which could reduce the risk of complications and duration of intubation while increasing the success rate among students and emergency medical technicians with little experience, rather than the existing method of only using direct laryngoscope, which requires considerable experience and skills.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.4
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• pp.189-193
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• 2013

We experienced dfficult airway management in a patient who had Ludwig angina with morbid obesity, dfficulty with mouth opening and neck extension. We planned to perform awake-nasotracheal intubation with fiberoptic bronchoscopy but the patient's condition was not suitable to do this procedure. Thus, we tried fiberoptic nasotracheal intubation under general anesthesia but we experienced difficult airway management due to epistaxis. We tried to use video laryngoscope instead of fiberpotic bronchoscopy but also failed to guide the tube into trachea due to limited mouth opening. We used video laryngoscope to make a view of vocal cord and used fiberoptic bronchoscope as an intubation guide of endotrachedal tube and successfully intubated the patient.

• The Korean Journal of Emergency Medical Services
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• v.15 no.3
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• pp.71-80
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• 2011

Purpose : This research was designed to provide basic data for advanced pre-hospital airway management by comparing the ease of intubation, the success rate and the time for intubation performed with Macintosh Laryngoscope, Gum Elastic Bougie and Pentax AirWay Scope on the floor and table. Methods : Intubation was performed 30 times in total, including 5 times for each of intubation using Macintosh Laryngoscope, Gum Elastic Bougie and Pentax Airway Scope on the table and floor, only on subjects who passed the practice test of the national exam for paramedics. Data were collected by measuring the ease of intubation, the success rate and the time for intubation, and then analyzed by descriptive analysis, paired t-test, ANOVA using SPSS 18.0. Results : 1. There was a significant difference in the ease of intubation according to intubation devices. 2. There was a significant difference in the ease of intubation according to table height for intubation. 3. There was a significant difference in the success rate according to intubation devices. 4. There was no significant difference in the success rate according to table height for intubation. 5. There was a significant difference in the intubation time according to intubation devices. 6. There was a partially significant difference in the intubation time according to table height for intubation. Conclusion : Sufficient training not only with Macintosh Laryngoscope but also with Gum Elastic Bougie and Pentax Airway Scope could improve the survival rate by intubation in patients with difficult airway.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.195-202
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• 2020

Background: Nasotracheal intubation is the most commonly used method to secure the field of view when performing surgery on the oral cavity or neck. Like orotracheal intubation, nasotracheal intubation uses a laryngoscope. Hemodynamic change occurs due to the stimulation of the sympathetic nervous system. Recently, video laryngoscope with a camera attached to the end of the direct laryngoscope blade has been used to minimize this change. In this study, we investigated the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses during nasotracheal intubation with a video laryngoscope. Methods: Twenty-one patients, aged between 19 and 60 years old, scheduled for elective surgery were included in this study. Anesthesia was induced by slowly injecting propofol. At the same time, remifentanil infusion was initiated at 3.0 ng/ml via target-controlled infusion (TCI). When remifentanil attained the preset Ce, nasotracheal intubation was performed using a video laryngoscope. The patient's blood pressure and heart rate were checked pre-induction, right before and after intubation, and 1 min after intubation. Hemodynamic stability was defined as an increase in systolic blood pressure and heart rate by 20% before and after nasotracheal intubation. The response of each patient determined the Ce of remifentanil for the next patient at an interval of 0.3 ng/ml. Results: The Ce of remifentanil administered ranged from 2.4 to 3.6 ng/ml for the patients evaluated. The estimated optimal effective effect-site concentrations of remifentanil were 3.22 and 4.25 ng/ml, that were associated with a 50% and 95% probability of maintaining hemodynamic stability, respectively. Conclusion: Nasotracheal intubation using a video laryngoscope can be successfully performed in a hemodynamically stable state by using the optimal remifentanil effect-site concentration (Ce₅₀, 3.22 ng/ml; Ce₉₅, 4.25 ng/ml).

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.2
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• pp.97-100
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• 2010

After introduction of operating microscopes and laser devices in the 1960's, monumental innovation for had been achieved in laryngeal microscopic surgery. The development of high-tech operating devices made the laryngeal surgery less invasive and more precise. There were long histories until developing of the modem instruments and surgical techniques. The simple oral mirror introduced by Bozzoni in 1807 is the beginning of laryngoscope. In 1859 Green carried out the laryngeal operation under direct view of larynx. The appearance of local topical anesthesia on throat had contributed to laryngeal surgery coming into wide use. Killian and Jackson made much contribution to developing the design of laryngoscope. After that, modem laryngeal surgery have been developed with development of the stabilizing holder of laryngoscope and optical devices. We propose carefully the direction of the development of the laryngeal surgery by historical consideration of laryngeal surgery and instrumental development.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.8.1-8
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• 1979

Microsurgery in otolaryngological field have been used of otomicrosurgery for middle ear operation and recently tend to be used more frepuently for laryngeal surgery. The authors had analyzed 63 cases of laryngeal mass under microsurgery with Suspension Laryngoscope from August '74 to April '79. The results are as follows; 1) The total cases of Suspension Laryngoscope was 63 ; 34 cases (54%) were male and 29 cases (46%) were female. Sex ratio was 1.2 : 1. 2) Age distribution shows 20 cases (37%) in 3rd decide, 10 cases (15.9%) in 4th decade, and 9 cases (14.3%) in 2nd decade. 3) The site of operation was 61 cases (96.8%) from glottic and 2 cases (3.2%) from supraglottic region. 4) The site of glottic region was 24 cases (38.1%) from bilateral, 22 cases (34.9%) from Rt., and 15 cases (14.3%) from Lt. 5) Pathologic findings of biopsy was Laryngeal nodule in 30 cases (47.6%), Squamous cell carcinoma in 10 cases (15.9%), Laryngeal polyp in 8 cases(12.7%), Laryngeal Papilloma in 5 cases (7.9%), and Non-specific inflammation in 5 cases (7.9%).

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.2
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• pp.133-138
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• 2010

Background and Objectives : High-speed imaging can be useful in studies of linguistic and artistic singing styles, and laryngeal examination of patients with voice disorders, particularly in irregular vocal fold vibrations. In this study, we introduce new laryngeal imaging systems which are commercially available high speed cameras connected with a laryngoscope. Materials and Method : The laryngeal images were captured from three different types of cameras. First, the adapter was made to connect with laryngoscope and Casio EX-F1 to capture the images using $2{\times}150$ Watt Halogen light source (EndoSTROB) at speeds of 1,200 tps (frame per second)($336{\times}96$). Second, Phantom Miro ex4 was used to capture the digital laryngeal images using Xenon Nova light source 175 Watt (STORZ) at speeds of 1,920 fps ($512{\times}384$). Finally, laryngeal images were captured using MotionXtra N-4 with 250 Watt halogen lamp (Olympus CLH-250) light source at speeds of 2,000tps ($384{\times}400$) by connecting with laryngoscope. All images were transformed into the Kymograph using KIPS (Kay's image processing Software) of Kay Pentex Inc. Results: Casio EX-F1 was too small to adjust the focus and screen size was diminished once the images were captured despite of high resolution images. High quality of color images could be obtained with Phantom Miro ex4 whereas good black and white images from Motion Xtra N-4 Despite of some limitations of illumination problems, limited recording time capacity, and time consuming procedures in Phantom Miro ex4 and Motion Xtra N-4, those portable devices provided high resolution images. Conclusion : All those high speed cameras could capture the laryngeal images by connecting with laryngoscope. High resolution images were able to be captured at the fixed position under the good lightness. Accordingly, these techniques could be applicable to observe the vocal fold vibration properties in the clinical practice.

• Korean Journal of Bronchoesophagology
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• v.9 no.1
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• pp.92-95
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• 2003

Laryngeal foreign bodies are not common among the foreign bodies of aerodigestive tract. It is relatively easy to diagnose in acute phase of entry because of a readily\ulcorner available history of intake, and signs or symptoms referable to the foreign body in the highly sensitive air passage. However, on occasion, sudden death by respiratory failure occurs due to complete obstruction of airway. Therefore, it is common and safe to remove the laryngeal foreign bodies by suspension laryngoscope under general anesthesia after tracheostomy. Recently, the authors experienced a case of metallic foreign body in larynx penetrating neck, which was removed by suspension laryngoscope under general anesthesia without any life threatening complication.

• Journal of Yeungnam Medical Science
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• v.35 no.2
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• pp.219-221
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• 2018

Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.