The potential uses and limitations of the flexible laryngoscopy under local anesthesia in clinical practice

Microsurgery of the larynx is commonly performed as direct laryngoscopy (DL ) under general anesthesia. An alternative in selected cases is flexible la ryngoscopy (FSL) under local anesthesia. We used a flexible laryngoscope th at contained an additional working tunnel (Olympus ENF Type T3). Local anae sthesia of the larynx was achieved with 1% oxybuprocaine-HCl. Tissue sample s were taken under endoscopic view and control. Twenty-five patients were s tudied and had benign lesions of the larynx or were being followed after tr eatment for cancer. The examination was tolerated well by all patients. The handling of the endoscope allowed precise targeting and sample taking. Due to the 2.2 mm diameter of the forceps the sizes of the biopsies were also limited. However, nearly all of the biopsies taken allowed sufficient histo logical examination. The advantage of the FSL was its simplicity and the mi nor inconvenience for patients. Although true histological results of suspe ct findings are possible, limitations in examining the hypopharynx prevent true staging of cancer patients. In general, FCL is a worthwhile complement to DL.