Video-assisted rigid endoscopic laryngosurgery: application to cases with difficult laryngeal exposure.

In some cases of microlaryngosurgery, laryngeal exposure with a direct laryngoscope is difficult because of a variety of reasons. In such cases, we now use a long rigid endoscope inserted into the side tube of the direct laryngoscope together with a video system. The lesion can be removed while the phonosurgeon observes the magnified images of the larynx on the video monitor. We describe the surgical procedure together with the preoperative and postoperative evaluation of vocal function in 13 patients with benign laryngeal lesions. A good surgical and vocal outcome was achieved in all cases. The method appeared to be useful for treating dysphonia in patients in whom it was difficult to expose the larynx with a direct laryngoscope.