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March 13, 1909


Author Affiliations

Surgeon to the Presbyterian Eye, Ear and Throat Hospital; Lecturer on Diseases of the Nose and Throat in University of Maryland BALTIMORE

JAMA. 1909;LII(11):881. doi:10.1001/jama.1909.25420370039004

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The old or mirror method of examining the larynx in children is crude and often unsatisfactory. Under general anesthesia the tongue is pulled out of the mouth, a small mirror is introduced and an attempt is made to see the larynx. Lucky, indeed, is the examiner if he can catch fleeting glimpses of the pathologic condition. Diagnosis under such circumstances is difficult, if not impossible.

The appearance of the direct laryngoscope was of decided advantage in the examination of children. With Killian's or Jackson's instrument and with the patient's head extended over the edge of the table, a satisfactory view of the larynx can be obtained in many cases. The extended position is a disadvantage, because the muscles of the neck and throat are all rigid and on the stretch and the examiner is in rather a cramped position. Though it is possible to operate successfully in this position, there

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