Uso de capa de proteção de câmera intraoral no exame de videolaringoscopia para doenças de laringe

Abstract

Introduction: laryngeal tumors are, worldwide, classified as the 11th most common type of cancer among men and the second most prevalent in terms of head and neck cancer. Therefore, attention is drawn to the relevance of the practice of exams for investigations, highlighting those performed using video laryngoscopy (VDL) equipment. However, a concern regarding this examination is biosafety, that is, measures adopted that can prevent cross-contamination through human biological material. In the case of the VDL exam, there is a protocol to be followed for the intermediate disinfection of the endoscope, and often, the time and cost of sterilizing the VDL device can hinder the agility of the exam and reduce the supply to the population. Therefore, the purpose of this thesis is to suggest the use of the Intraoral Camera Protection Cover (CPCIO), through the VDL technique. Objectives: to map the available evidence on the VDL exam as a diagnostic tool for laryngeal cancer; analyze the perspective of otorhinolaryngologists in relation to images of malignant lesions on the vocal folds obtained from VDL exams performed with and without the use of a protective cover; analyze the impact of using CPCIO on VDL procedures applied in cases of laryngeal diseases, specifically, in relation to cost savings and agility in carrying out exams. Method: study with a cross-sectional design, of a quantitative nature, about VDL images from three perspectives: scoping review, analysis by medical professionals on VDL exam images captured at the teaching hospital located in Curitiba/PR; analysis of the cost-benefit magnitude of CPCIO in VDL exams. Results: Article 1: the findings in the literature revealed by the scoping review showed associations between laryngeal pathologies, including laryngeal cancer, and VDL imaging. However, it is worth highlighting the restriction in the interpretation of results due to the lack of quality assessment of the included studies; Article 2: otorhinolaryngologists at the teaching hospital agreed that the use of CPCIO in the VDL examination did not interfere in the diagnosis of laryngeal cancer in patients who presented malignant lesions in the videos watched; Article 3: the use of CPCIO in VDL exams has a financial impact on their costs, providing agility in their execution and, thus, providing opportunities for a greater number of exams to be carried out in the public health network of the Unified Health System (SUS). Conclusion: the use of CPCIO did not interfere with the image quality for the diagnosis of pre-malignant lesions of the vocal folds. The cost resulting from this use is diluted by increasing the availability of tests to the population, which means prevention of cancer diagnosis, as well as a reduction in cases, leading to a reduction in investment (medication, hospitalizations and others) by the network. public interest in the treatment of this disease. However, studies must be carried out to validate the use of CPCIO in VDL exams and, in this sense, provoke the implementation of public policies in the area of health in the search to ensure quality of life for patients with laryngeal injuries, as well as adequate conditions for execution of these exams to the team that performs them.