부산대학교 도서관

On performing endoscopic microsurgeries of the larynx, a conventional intubation tube may interfere not only with full exposure of entire portion of the true vocal folds but with delicate manupulation by utilizing microinstruments upon pathological changes in the vocal folds. The reason for such obstacles to be met is because the size of a conventional intubation tube is too large in its outer diameter at the level of the true vocal folds.A newly devised intubation tube, therefore, is made significantly smaller in its outer diameter for endoscopic microsurgeries. This new intubation tube comprised of two segments which are directly connected by adhesive material; it is a compounded tube, having different lumen sizes between the central and the periphery of both proximal and distal segments. The central portion of the tube is only 25mm in its length. The size of this shorter central seg ment of the tube is either French 20 or 22 which connects respectively with either French 32 or 34 in its proximal and distal segments. The cuff is of adult size. A compound tube of French 22 in its central with French 34 in the periphery parts is employed for the adult male while French 32-20-32 is used for the adult female and children. The central portion of the tube must be positioned at the level of the true vocal folds so that significant enlargement of the operating field in the larynx for allowing a surgeon the finest endoscopic microsurgeries is evident.Basic respiratory studies including flow resistance tests of this type of intubation tube and also blood gas analysis before, during and after general anesthesia with this tube are conducted with favorable results. It is concluded as a results of flow resistance studies that a newly devised intubation tube of French 34-22-34 corresponds to a conventional tube of French 26 while French 32-20-32 has approximately the same flow resistance as a conventional tube of French 24; with a newly devised intubation tube, therefore, one can significantly decrease the outer diameter of a conventional tube by the degree of French 4 or by 1. 33mm at the level of the glottis.Clinical experiences with this intubation tube in 308 cases with various pathologies of the larynx showed not only safety throughout all procedures but no complications encountered.