{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:02:38Z","timestamp":1790910158632,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is increasing prevalence of single\u2010use flexible laryngoscopes in Otolaryngology. This study aims to quantify and compare the environmental outcomes of single\u2010use disposable flexible laryngoscopes (SUD\u2010Ls) and reusable flexible laryngoscope (R\u2010Ls).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The ISO 14040 standardized Life Cycle Assessment (LCAs) was utilized to estimate the environmental footprint of SUD\u2010L and R\u2010L. Product and packaging material composition, energy and water consumption, and high\u2010level disinfection products were tabulated from on\u2010site observation, manufacturer data, and the Ecoinvent database. Global warming impacts were defined by greenhouse gas emissions (GHGs) quantified by kilograms of carbon dioxide equivalents (kgCO\n                      <jats:sub>2<\/jats:sub>\n                      \u2010eq) and analyzed using the US EPA's TRACI and SimaPro software. Monte Carlo sensitivity analyses were additionally performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Assuming a 6\u2010year lifespan and 218 laryngoscopies\/year, the R\u2010L saves 804 kgCO\n                      <jats:sub>2<\/jats:sub>\n                      \u2010eq compared to SUD\u2010L (1816 vs 2619 kgCO\n                      <jats:sub>2<\/jats:sub>\n                      \u2010eq). Notably 63% of the R\u2010L total GHGs were due to personal protective equipment (PPE) production and disposal used in reprocessing, whereas 79% of SUD\u2010L total GHGs were attributed to scope manufacturing and production. In a break\u2010even analysis, a R\u2010L produces fewer lifespan GHGs than SUD\u2010Ls after 82 uses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Reusable flexible laryngoscopes pose an environmental benefit over SUD\u2010Ls across several impact categories when used in high frequency. SUD\u2010Ls have significant advantages in various situations: low utilization settings, in\u2010patient\/ED consults, and urgent need for sterile instrumentation. Providers should assess laryngoscope use frequency, site of use, and available resources to balance the environmental consequences. Further areas of sustainable optimization include reducing disposable PPE used in R\u2010L reprocessing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      NA\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 135:1666\u20131673, 2025\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.31927","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T08:06:22Z","timestamp":1735200382000},"page":"1666-1673","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A Comparison of Environmental Impacts Between Reusable and Disposable Flexible Laryngoscopes"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3654-052X","authenticated-orcid":false,"given":"Joseph","family":"Kidane","sequence":"first","affiliation":[{"name":"Caruso Department of Otolaryngology\u2010Head and Neck Surgery University of Southern California  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra L.","family":"Thiel","sequence":"additional","affiliation":[{"name":"Department of Population Health, Department of Ophthalmology New York University Langone Health  New York City New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiyi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of California San Francisco  San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-1086","authenticated-orcid":false,"given":"Clark A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of California San Francisco  San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1121\/1.1910752"},{"key":"e_1_2_6_3_1","unstructured":"YangR.Chip\u2010on\u2010tip technology expands endoscopy's use in localized procedures. Accessed June 13 2023.https:\/\/www.photonics.com\/Articles\/Chip-on-Tip_Technology_Expands_Endoscopys_Use_in\/a66501."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215120001656"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820923623"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","unstructured":"CooperF ShakeelM.Laryngoscopy for thyroidectomy patients using a portable sine flexible laryngoscope (Ambu\u00ae aScope\u2122 4 RhinoLaryngo Slim): adaptation during covid\u201019 pandemic.2020https:\/\/doi.org\/10.31579\/2692-9562\/014.","DOI":"10.31579\/2692-9562\/014"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.01247"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1610"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157014"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.303846"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.112139"},{"key":"e_1_2_6_12_1","unstructured":"DuijndamJ.Sustainable device selection for flexible intubation scopes: comparative environmental impact assessment of disposable and reusable flexible intubation scopes and concept design for sustainable flexible intubation scopes.2022. Accessed September 27 2022.https:\/\/repository.tudelft.nl\/islandora\/object\/uuid%3Ab638ee2c\u2010059c\u20104a9e\u2010bc9d\u2010e26d4c44cdc1."},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.11648\/j.ajep.20180704.11"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2022.0201"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2022.06.014"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-324729"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2018.0001"},{"key":"e_1_2_6_18_1","volume-title":"ISO 14040:2006 Environmental Management Environmental Management \u2014 Life Cycle Assessment \u2014 Principles and Framework","author":"14:00\u201017:00. International Organization for Standardization","year":"2006"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1065\/lca2004.10.181.1"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10098-010-0338-9"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.1190"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2011.04.007"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annfar.2013.01.014"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002683"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31824f6959"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31824d9cc3"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2018.02.002"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30866"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31341"},{"key":"e_1_2_6_30_1","unstructured":"United States Department of State and the United States Executive Office of the President.The long\u2010term strategy of the united states: pathways to net\u2010zero greenhouse gas emissions by 2050.2021.https:\/\/www.whitehouse.gov\/wp\u2010content\/uploads\/2021\/10\/us\u2010long\u2010term\u2010strategy.pdf."}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31927","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.31927","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31927","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:26:56Z","timestamp":1780028816000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31927"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,26]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/lary.31927"],"URL":"https:\/\/doi.org\/10.1002\/lary.31927","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,26]]},"assertion":[{"value":"2024-05-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}