{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:21:54Z","timestamp":1786980114440,"version":"build-2736575974"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T00:00:00Z","timestamp":1583280000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T00:00:00Z","timestamp":1583280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Since many years, office-based flexible transnasal laryngoscopy is a common routine procedure. The development of new technical equipment such as high-definition cameras and flexible tip-chip endoscopes nowadays allows for much more precise examination than a few years ago. In contrast to rigid laryngoscopy, it is possible to move the tip of the endoscope close to the vocal folds and to other structures of interest. Nevertheless, without professional handling of the equipment, one cannot benefit from the potential of the newest technology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Two easily performed and very helpful maneuvers in flexible endoscopy are described. The \u201cdipping maneuver\u201d enables a maximum magnification of the mucosal surfaces of the endolarynx as well as the examination of the subglottal region and the trachea by positioning the tip of the endoscope very close to the vocal folds or even in the upper trachea during long transnasal inspiration. During the \u201crotation laryngoscopy\u201d, the tip of the endoscope is positioned in the posterior interarytenoid region by rotating the flexible endoscope by 180\u00b0 and advancing it close to the glottis. This allows a close-up examination of the anterior commissure, the inferior aspect of the vocal folds and the inside of the Morgagni\u2019s ventricle. Before performing transnasal flexible endoscopy, we routinely apply topical anesthesia sprayed intranasally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The described techniques of flexible endoscopy are easily performed and allow a maximum magnification of the mucosal surfaces and otherwise not visible regions of the endolarynx.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-020-05862-7","type":"journal-article","created":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T09:03:02Z","timestamp":1583312582000},"page":"1545-1549","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Dipping and rotating: two maneuvers to achieve maximum magnification during indirect transnasal laryngoscopy"],"prefix":"10.1007","volume":"277","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6440-0968","authenticated-orcid":false,"given":"Susanne","family":"Fleischer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Pflug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Hess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,4]]},"reference":[{"key":"5862_CR1","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1177\/000348948909800906","volume":"98","author":"RW Bastian","year":"1989","unstructured":"Bastian RW, Collins SL, Kaniff T, Matz GJ (1989) Indirect video-laryngoscopy versus direct endoscopy for larynx and pharynx cancer staging. Toward elimination of preliminary direct laryngoscopy. Ann Otol Rhinol Laryngol 98:693\u2013698","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"5862_CR2","series-title":"Laryngology","volume-title":"Sataloff\u2019s comprehensive textbook of otolaryngology head and neck surgery","author":"SRA Best","year":"2016","unstructured":"Best SRA, Akst LM (2016) Visualizing the larynx. In: Benninger MS (ed) Sataloff\u2019s comprehensive textbook of otolaryngology head and neck surgery. Laryngology, 1st edn. Jaypee Brothers Medical Publishers, New Delhi","edition":"1"},{"key":"5862_CR3","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1002\/lary.27506","volume":"129","author":"A Ghodke","year":"2019","unstructured":"Ghodke A, Farquhar DR, Buckmire RA, Shah RN (2019) Office-based laryngology: technical and visual optimization by patient-positioning maneuvers. Laryngoscope 129:330\u2013334","journal-title":"Laryngoscope"},{"key":"5862_CR4","volume-title":"The voice clinic handbook","author":"J McGlashan","year":"2018","unstructured":"McGlashan J (2018) Visual examination of the larynx and the vocal tract. In: Harris T, Howard DM (eds) The voice clinic handbook. Compton Publishing, Oxford"},{"key":"5862_CR5","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1001\/jamaoto.2017.0120","volume":"143","author":"KA Russell","year":"2017","unstructured":"Russell KA, Brook CD, Platt MP, Grillone GA, Aliphas A, Noordzij JP (2017) The benefits and limitations of targeted training in flexible transnasal laryngoscopy diagnosis. JAMA Otolaryngol Head Neck Surg 143:707\u2013711","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"5862_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2018.11.006","author":"H Tasli","year":"2018","unstructured":"Tasli H, Birkent H, Karakoc O, Gokgoz MC (2018) Optimal position for transnasal flexible laryngoscopy. J Voice. https:\/\/doi.org\/10.1016\/j.jvoice.2018.11.006","journal-title":"J Voice"},{"key":"5862_CR7","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/j.jvoice.2018.02.019","volume":"33","author":"H Tasli","year":"2019","unstructured":"Tasli H, Karakoc O, Birkent H (2019) A grading system for transnasal flexible laryngoscopy. J Voice 33:712\u2013715","journal-title":"J Voice"},{"key":"5862_CR8","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.jvoice.2017.10.005","volume":"33","author":"WG Young","year":"2019","unstructured":"Young WG, Shama L, Petty B, Hoffman MR, Dailey SH (2019) Comparing videostroboscopy and direct microlaryngoscopy: an argument for flexible consent and operative plan. J Voice 33:143\u2013149","journal-title":"J Voice"},{"key":"5862_CR9","doi-asserted-by":"publisher","first-page":"S185","DOI":"10.1002\/lary.20712","volume":"119","author":"CA Rosen","year":"2009","unstructured":"Rosen CA, Milan RA, Lucian S, Simpson CB, Merati AL, Courey MS, Johns MM, Postma GN (2009) Advances in office-based diagnosis and treatment in laryngology. Laryngoscope 119:S185\u2013S214","journal-title":"Laryngoscope"},{"key":"5862_CR10","unstructured":"Fleischer S, Hess M (2015) Office-based laryngoscopy. Instructional Manual. https:\/\/stimmklinik.de\/wp-content\/uploads\/2019\/08\/Manual_Office-Based-Laryngoscopy_Fleischer_Hess_2015.pdf. Accessed 2019"},{"key":"5862_CR11","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1017\/S0022215118001093","volume":"132","author":"TC Biggs","year":"2018","unstructured":"Biggs TC, Henderson A, Shelton F, Patel NN (2018) The use of visual distraction to improve the tolerability of flexible laryngoscopy. J Laryngol Otol 132:739\u2013741","journal-title":"J Laryngol Otol"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-020-05862-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00405-020-05862-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-020-05862-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T19:38:37Z","timestamp":1614800317000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00405-020-05862-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,4]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["5862"],"URL":"https:\/\/doi.org\/10.1007\/s00405-020-05862-7","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,4]]},"assertion":[{"value":"3 January 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants or animals performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}}]}}