Direct laryngoscopy: a prospective study

ABSTRACT

Prospective clinical analysis of direct laryngoscopic procedures performed in Mosul Teaching Hospital Iraq. Patients and 100 direct laryngoscopic procedures performed in the period from September 1996 to June 1997. There were 55 males and 45 females. The average age was 42.8 years. The most common surgical indications were hoarseness [77%] and tumor-like mass detected on indirect laryngoscopy [38%]. Laryngeal squamous cell carcinoma [SCC] was the most common final diagnosis in the malignant cases. Chronic nonspecific laryngitis was the most common benign diagnosis. The diagnostic accuracy of indirect mirror laryngoscopy compared to direct laryngoscopy was 61%. The diagnostic accuracy of direct laryngoscopic findings and histological diagnosis was 87%. Direct laryngoscopy was difficult in 3 patients, those with short and muscular neck structure. The incidence of major complications was at least 4%. Minor complications occurred in 7% of the patients. Laryngospasm was significantly higher in patients who underwent direct laryngoscopy along with other procedures than in those who underwent direct laryngoscopy alone. Conclusions: Direct laryngoscopy was performed most often indicated for chronic hoarseness and tumor-like masses detected on indirect laryngoscopy. Laryngeal SCC was the most common malignancy and chronic nonspecific laryngitis was the most common non-malignant finding. The incidence of major complications was 4%. Laryngospasm was significantly higher in patients who had undergone procedures in addition to direct laryngoscopy. It is felt that patients who undergo direct laryngoscopy are most safely managed as in patients for 24 hours