Abstract
Worldwide, thousands of people suffer from laryngeal diseases, many of which involve the posterior glottis or subglottis. These laryngeal areas are challenging to visualize with conventional transnasal and transoral laryngoscopes because the view from above is obscured by the disease itself, thereby limiting the efficacy of endoscopy in diagnosis and treatment. Advancements in miniaturized optical systems overcome these limitations and allow for real-time visualization of difficult-to-access laryngeal subsites such as the posterior glottis and subglottis. The present study introduces a novel device, the subglottic imaging puncture scope (SIPS), to access and image the subglottic space via a transcervical puncture. The SIPS has a miniature, high-resolution camera integrated within a medical-grade gauge 18 needle. The small-diameter needle allows for minimal invasiveness, similar to established laryngeal therapeutic drug delivery techniques. A detailed description of the camera and light source alignments are provided. Images from video footage obtained in human cadavers are provided, validating the hypothesis that a minimally invasive device allows imaging of the subglottis. The SIPS will improve diagnostic accuracy and patient comfort, enabling the full extent of subglottic pathology to be imaged on awake patients in a clinical office setting.