Fiberoptic Laryngeal Microsurgery in Patients with Cervical Spine Disease

Laryngeal microsurgery using suspension laryngoscope is a common procedure for benign laryngeal lesions. However, suspension laryngoscope could not always guarantee adequate exposure of the vocal cord in patients having stiff neck. Here we present a novel operative method to overcome difficult laryngeal exposure in patients with cervical spine diseases. A 71-year-old man presented with hoarseness. Laryngeal evaluation showed a vocal polyp located at the anterior portion of right true vocal cord. He previously underwent partial laminectomy of cervical and thoracic vertebrae for ossified ligamentum flavum. During operation, suspension rigid laryngoscope was not able to be introduced at the true vocal cord level due to a limited neck extension caused by spine immobilization and further concern was taken for potential damage of spinal cord. We performed fiberoptic laryngeal microsurgery assisted with McGRATH^® portable video laryngoscope and successfully removed the vocal polyp. Fiberoptic laryngeal microsurgery assisted with McGRATH^® portable video laryngoscope might be an alternative approach in selected patients of difficult laryngeal exposure especially due to cervical spine disease. (J Clinical Otolaryngol 2014;25:271-275)